Provider Demographics
NPI:1467211607
Name:SHELMAN, SHELBY ROSE (LCPO)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:ROSE
Last Name:SHELMAN
Suffix:
Gender:F
Credentials:LCPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 S 348TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7021
Mailing Address - Country:US
Mailing Address - Phone:253-952-3887
Mailing Address - Fax:
Practice Address - Street 1:922 S 348TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7021
Practice Address - Country:US
Practice Address - Phone:253-952-3887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist