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Individual

MISS SHAWNA MARIE GAMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
475 BEDICO PKWY, MADISONVILLE, LA 70447-3274
(561) 701-3189
Mailing address
475 BEDICO PKWY, MADISONVILLE, LA 70447-3274
(561) 701-3189

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00013373
WA
225700000X
Massage Therapist
Primary
LA10336
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
190471
LABOR AND INDUSTRIES
WA
Enumeration date
05/22/2007
Last updated
03/11/2026
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