Provider Demographics
NPI:1174126056
Name:CANAS, SHAWNA MICHELLE (LMT)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MICHELLE
Last Name:CANAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:SHAWNA
Other - Middle Name:
Other - Last Name:CANAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:1026 87TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-2457
Mailing Address - Country:US
Mailing Address - Phone:425-953-3607
Mailing Address - Fax:
Practice Address - Street 1:1026 87TH AVE NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-2457
Practice Address - Country:US
Practice Address - Phone:425-953-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60329059225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist