Provider Demographics
NPI:1811261787
Name:REIMER, SHELLEY BLAIN (LMT)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:BLAIN
Last Name:REIMER
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 1:321 HIGH SCHOOL RD NE
Mailing Address - Street 2:SUITE D-3 PMB 288
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2647
Mailing Address - Country:US
Mailing Address - Phone:206-842-2702
Mailing Address - Fax:206-842-2847
Practice Address - Street 1:701 WINSLOW WAY E STE B
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2416
Practice Address - Country:US
Practice Address - Phone:206-842-2702
Practice Address - Fax:206-842-2847
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006803225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist