Healthcare Provider Details

I. General information

NPI: 1013842442
Provider Name (Legal Business Name): HANNAH SHIPLEY MA00022956
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 ROOSEVELT AVE STE 6
MOUNT VERNON WA
98273-2687
US

IV. Provider business mailing address

15462 MCLEAN RD
MOUNT VERNON WA
98273-8729
US

V. Phone/Fax

Practice location:
  • Phone: 360-941-9345
  • Fax:
Mailing address:
  • Phone: 360-941-9345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00022956
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: