Provider Demographics
NPI:1851020945
Name:SHEHEE, SHANE FARREL
Entity Type:Individual
Prefix:
First Name:SHANE
Middle Name:FARREL
Last Name:SHEHEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 ILLINOIS AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3908
Mailing Address - Country:US
Mailing Address - Phone:202-221-1522
Mailing Address - Fax:
Practice Address - Street 1:2301 11TH ST NW APT 115
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2245
Practice Address - Country:US
Practice Address - Phone:202-847-8363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant