Individual
ALYSE SHAPAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 MATTHEW ST, SUITE 200, MARIETTA, OH 45750-1644
(740) 434-0565
(740) 434-0563
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004416
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144540
—
OH
Enumeration date
09/16/2015
Last updated
07/15/2024
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