Provider Demographics
NPI:1700236528
Name:COX, SHAWNA KAY (LMT)
Entity Type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:KAY
Last Name:COX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 LESLIE RD APT 65
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7679
Mailing Address - Country:US
Mailing Address - Phone:509-619-4318
Mailing Address - Fax:509-628-9643
Practice Address - Street 1:83 KEENE RD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-5006
Practice Address - Country:US
Practice Address - Phone:509-737-1461
Practice Address - Fax:509-628-9643
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60600165225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist