MEDICARE: TYLER MICHAEL SHEA LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	138924	AK

General Provider Information

NPI Number	:	1043842289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER MICHAEL SHEA LMT

Provider Business Mailing Address
First Line	:	10 PIER 1 STE 308
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-6338
Country	:	US
Telephone Number	:	503-974-0914
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 PIER 1 STE 308
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-6338
Country	:	US
Telephone Number	:	503-974-0914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2020
Last Update Date	:	03/27/2025

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Directions to “ TYLER MICHAEL SHEA LMT” Practice Location

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