Provider Demographics
NPI:1942795737
Name:KAUFFMAN, SHAWNA DAY (LMT)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:DAY
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 SW TUALATIN SHERWOOD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8620
Mailing Address - Country:US
Mailing Address - Phone:503-757-5086
Mailing Address - Fax:
Practice Address - Street 1:8215 SW TUALATIN SHERWOOD RD STE 200
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8620
Practice Address - Country:US
Practice Address - Phone:503-757-5086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17585225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist