Provider Demographics
NPI:1518306026
Name:OROURKE, SHEENA MARIE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:MARIE
Last Name:OROURKE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:SHEENA
Other - Middle Name:MARIE
Other - Last Name:BARCLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98666-0311
Mailing Address - Country:US
Mailing Address - Phone:360-771-9930
Mailing Address - Fax:
Practice Address - Street 1:2702 NE 78TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-0665
Practice Address - Country:US
Practice Address - Phone:360-573-4813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60126493225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist