Provider Demographics
NPI:1881040830
Name:SETH, SHAWNA SAVITRI (PA-S, LAC)
Entity type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:SAVITRI
Last Name:SETH
Suffix:
Gender:F
Credentials:PA-S, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 CLIFTON RD NE STE 280
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1063
Mailing Address - Country:US
Mailing Address - Phone:404-727-7825
Mailing Address - Fax:
Practice Address - Street 1:1462 CLIFTON RD NE STE 280
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1063
Practice Address - Country:US
Practice Address - Phone:404-727-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16991171100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171100000XOther Service ProvidersAcupuncturist