MEDICARE: SHANNON EGAN 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	MA61630297	WA

General Provider Information

NPI Number	:	1235025404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON EGAN LMT

Provider Business Mailing Address
First Line	:	12015 E 26TH AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-7035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12015 E 26TH AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-7035
Country	:	US
Telephone Number	:	805-471-0142
Fax Number	:

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

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	06/16/2025

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Directions to “ SHANNON EGAN LMT” Practice Location

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