Provider Demographics
NPI:1922519800
Name:CARTER, SHAUNA KELEEN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:KELEEN
Last Name:CARTER
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3562 WESTCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9732
Mailing Address - Country:US
Mailing Address - Phone:541-410-3499
Mailing Address - Fax:
Practice Address - Street 1:116 3RD ST STE 215
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2193
Practice Address - Country:US
Practice Address - Phone:800-277-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist