Healthcare Provider Details

I. General information

NPI: 1902817380
Provider Name (Legal Business Name): SHANNON EM ARNDT MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2864 ANDREASON RD
LANGLEY WA
98260
US

IV. Provider business mailing address

PO BOX 260
LANGLEY WA
98260-0260
US

V. Phone/Fax

Practice location:
  • Phone: 360-321-4434
  • Fax: 360-321-4434
Mailing address:
  • Phone: 360-321-4434
  • Fax: 360-321-4434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPU20001094
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: