Provider Demographics
NPI:1851527352
Name:HARRIS-SHEARS, MATTHEW AARON (ATC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:AARON
Last Name:HARRIS-SHEARS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:AARON
Other - Last Name:SHEARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:2450 DEXTER AVE N APT 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2223
Mailing Address - Country:US
Mailing Address - Phone:623-363-1921
Mailing Address - Fax:
Practice Address - Street 1:2450 DEXTER AVE N APT 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2223
Practice Address - Country:US
Practice Address - Phone:623-363-1921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer