MEDICARE: LINDA SHAWN MCGILL LMP

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	MA 60145347	WA

General Provider Information

NPI Number	:	1184068504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA SHAWN MCGILL LMP

Provider Business Mailing Address
First Line	:	5409 17TH AVE NW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3818
Country	:	US
Telephone Number	:	206-784-3895
Fax Number	:	206-784-7471

Provider Business Practice Location Address
First Line	:	5409 17TH AVE NW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3818
Country	:	US
Telephone Number	:	206-784-3895
Fax Number	:	206-784-7471

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

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	04/29/2013

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