Provider Demographics
NPI:1952019226
Name:SAWYER, SHAINA LYNN (LMT, CLT)
Entity Type:Individual
Prefix:MISS
First Name:SHAINA
Middle Name:LYNN
Last Name:SAWYER
Suffix:
Gender:F
Credentials:LMT, CLT
Other - Prefix:
Other - First Name:SHAINA
Other - Middle Name:LYNN
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5423 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-9789
Mailing Address - Country:US
Mailing Address - Phone:734-881-2000
Mailing Address - Fax:
Practice Address - Street 1:5423 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9789
Practice Address - Country:US
Practice Address - Phone:734-881-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7501005570OtherMASSAGE THERAPY