Provider Demographics
NPI:1922386515
Name:SHAVER, ASHLEY N (LMP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:SHAVER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16516 E TEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-9275
Mailing Address - Country:US
Mailing Address - Phone:509-714-0220
Mailing Address - Fax:
Practice Address - Street 1:10709 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1631
Practice Address - Country:US
Practice Address - Phone:509-466-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60212167225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist