Provider Demographics
NPI:1265887103
Name:ZEPHYR, SHAWNIE (LMT)
Entity type:Individual
Prefix:
First Name:SHAWNIE
Middle Name:
Last Name:ZEPHYR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SHAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1149
Mailing Address - Country:US
Mailing Address - Phone:541-228-2232
Mailing Address - Fax:541-228-2232
Practice Address - Street 1:29 SHAWNEE DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1149
Practice Address - Country:US
Practice Address - Phone:541-228-2232
Practice Address - Fax:541-228-2232
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22113225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR22113OtherSTATE MASSAGE THERAPY LICENSE NUMBER