Provider Demographics
NPI:1689224958
Name:ZIEMER, SHAWNA JONE-KAI (MPO)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:JONE-KAI
Last Name:ZIEMER
Suffix:
Gender:F
Credentials:MPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8530 184TH ST SW
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-5706
Mailing Address - Country:US
Mailing Address - Phone:405-414-3755
Mailing Address - Fax:
Practice Address - Street 1:1300 44TH ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2200
Practice Address - Country:US
Practice Address - Phone:425-339-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60705149222Z00000X
WA60650522224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist