Provider Demographics
NPI:1447560727
Name:SHOR, STEVEN (LMP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SHOR
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:SHOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:5719 29TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5521
Mailing Address - Country:US
Mailing Address - Phone:206-909-7962
Mailing Address - Fax:
Practice Address - Street 1:5719 29TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5521
Practice Address - Country:US
Practice Address - Phone:206-909-7962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60189146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist