Provider Demographics
NPI:1578675351
Name:ECHELBARGER, SHELBY E (MPT)
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:E
Last Name:ECHELBARGER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21701 76TH AVE W #304
Mailing Address - Street 2:SEBBY PHYSICAL THERAPY
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026
Mailing Address - Country:US
Mailing Address - Phone:425-744-1717
Mailing Address - Fax:425-744-1736
Practice Address - Street 1:21701 76TH AVE W #304
Practice Address - Street 2:SEBBY PHYSICAL THERAPY
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026
Practice Address - Country:US
Practice Address - Phone:425-744-1717
Practice Address - Fax:425-744-1736
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P54980Medicare UPIN