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NPI Code Detail

MEDICARE: SHANNON AVILA

MEDICARE: SHANNON AVILA
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
1225700000XMassage TherapistMA00024096WA

General Provider Information

NPI Number : 1407035801
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON AVILA
Provider Business Mailing Address
First Line : 1422 31ST AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98144-3910
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1422 31ST AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98144-3910
Country : US
Telephone Number : 206-322-1770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2007
Last Update Date : 11/01/2007

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Directions to “ SHANNON AVILA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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