Provider Demographics
NPI:1902817380
Name:ARNDT, SHANNON EM (MSPT)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:EM
Last Name:ARNDT
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-0260
Mailing Address - Country:US
Mailing Address - Phone:360-321-4434
Mailing Address - Fax:360-321-4434
Practice Address - Street 1:2864 ANDREASON RD
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260
Practice Address - Country:US
Practice Address - Phone:360-321-4434
Practice Address - Fax:360-321-4434
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPU20001094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist