SHANE CHRISTOPHER CLYBURN (NPI# 1659541761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659541761 |
| Entity Type | Individual |
| Full Name | SHANE CHRISTOPHER CLYBURN |
| Other Name | SHANE CHRISTOPHER SHEROD-CLYBURN |
| Credential | LMP |
| Practice Address |
6965 Coal Creek Pkwy Se Newcastle WA 98059-3136 |
| Practice Telephone | 4256417470 |
| Practice Fax Number | 4253739176 |
| Mailing Telephone | 4256417470 |
| Mailing Fax Number | 4253739176 |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00019071 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LABOR AND INDUSTRIES | 0229693 | 01 |
| Street Address |
6965 COAL CREEK PKWY SE |
| City | NEWCASTLE |
| State | WA |
| Zip Code | 98059-3136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265595375 | Melinda A. Maxwell | Chiropractor | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2006-12-19 |
| 1225676513 | Abigail Lois Rausch | Massage Therapist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2019-12-17 |
| 1477102978 | Juanita Cazares | Massage Therapist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2019-09-06 |
| 1093121899 | Ashley Robinson | Massage Therapist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2014-07-01 |
| 1669741807 | Brittany Rae-lynn Hazzard | Massage Therapist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2011-12-16 |
| 1750679825 | Wesley Allen Robinson | Chiropractor | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2011-07-11 |
| 1336439769 | Amber Olivia Hickman | Specialist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2011-04-19 |
| 1104077270 | Chastity J Garcia | Specialist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2008-10-07 |
| 1780877126 | Chiropractic Wellness Centers Ps Inc | Chiropractor | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2007-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346724358 | Vanessa Sequeira | Massage Therapist | 13293 Newcastle Commons Dr, Newcastle, WA 98059 | 2018-09-17 |
| 1417477720 | Karen Apple | Behavior Technician | 13804 Se 76th Pl, Newcastle, WA 98059 | 2017-06-27 |
| 1992234256 | Justin Studer | Massage Therapist | 950 Field Ave Ne, Renton, WA 98059 | 2017-06-08 |
| 1770983306 | Pooja Walia Bhardwaj | Dentist | 6935 Coal Creek Pkwy Se, Newcastle, WA 98059 | 2014-09-02 |
| 1487799334 | Ai-lien Ngoc Sperry | Dentist | 4820 Ne 4th St, Suite A-108, Renton, WA 98059 | 2007-02-20 |
| 1225172711 | Vicki L Finesilver-quinn | Social Worker | 13741 148th Pl. Se, Renton, WA 98059 | 2007-02-16 |
| 1467511535 | Baljinder S Buttar | Dentist | 4501 Ne 4th St, Suite A, Renton, WA 98059 | 2006-12-06 |
| 1992892913 | Kevin Keith Kay | Dentist | 4444 Ne Sunset Blvd, Suite 3, Renton, WA 98059 | 2006-10-10 |
| 1194714790 | Dale E Epper Md | Family Medicine | 4444 Sunset Blvd, Dale E Epper Md Dba Highlands Family Practice, Renton, WA 98059 | 2005-10-17 |
| 1497219661 | Evelyn Faith Lafferty | Massage Therapist | 6985 Coal Creek Pkwy Se, Newcastle, WA 98059 | 2019-01-22 |
| Find all providers in zip 98059 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265065916 | Patricia Corscaden | Massage Therapist | 61 Lewis Hill Rd, Newcastle, ME 04553-3921 | 2020-02-20 |
| 1346724358 | Vanessa Sequeira | Massage Therapist | 13293 Newcastle Commons Dr, Newcastle, WA 98059 | 2018-09-17 |
| 1700012952 | Malissa Lee Landry | Massage Therapist | 17 Lincoln Ln, Newcastle, ME 04553-3313 | 2009-06-02 |
| 1992946164 | Tami Mason | Massage Therapist | 7453 Newcastle Golf Club Rd, C205, Newcastle, WA 98059-3029 | 2009-03-17 |
| 1194719906 | Jesus O Dela Torre Hernandez | Massage Therapist | 6985 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2005-09-07 |
| 1225676513 | Abigail Lois Rausch | Massage Therapist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2019-12-17 |
| 1861038242 | Hongxia Zheng | Massage Therapist | 6985 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2019-11-21 |
| 1477102978 | Juanita Cazares | Massage Therapist | 6965 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2019-09-06 |
| 1316403652 | Nelson Jeck | Massage Therapist | 6985 Coal Creek Pkwy Se, Newcastle, WA 98059-3136 | 2019-02-12 |
| 1497219661 | Evelyn Faith Lafferty | Massage Therapist | 6985 Coal Creek Pkwy Se, Newcastle, WA 98059 | 2019-01-22 |
| Find all providers in NEWCASTLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.