Individual
JAMES M.R. SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
17903 16TH AVE W, LYNNWOOD, WA 98037-4048
(425) 984-4426
Mailing address
17903 16TH AVE W, LYNNWOOD, WA 98037-4048
(425) 984-4426
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009899
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200941
WA STATE L&I
WA
05
—
8435596
—
WA
01
—
9516SH
REGENCE BLUE SHIELD
WA
Enumeration date
05/26/2006
Last updated
07/14/2023
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