Provider Demographics
NPI:1588847214
Name:SHIELDS, RAMONA L (PT)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:L
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 NW ANDERSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-6807
Mailing Address - Country:US
Mailing Address - Phone:360-698-6300
Mailing Address - Fax:360-698-7002
Practice Address - Street 1:4409 NW ANDERSON HILL RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-6807
Practice Address - Country:US
Practice Address - Phone:360-698-6300
Practice Address - Fax:360-698-7002
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist