SHANNON RENAE WAKEM (NPI# 1710149786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710149786 |
| Entity Type | Individual |
| Full Name | SHANNON RENAE WAKEM |
| Credential | OTR |
| Practice Address |
8995 Sw Miley Rd Ste 109 Wilsonville OR 97070-5485 |
| Mailing Address |
Po Box 1114 Canby OR 97013-1114 |
| Practice Telephone | 5036948366 |
| Practice Fax Number | 5036948581 |
| Mailing Telephone | 5033183927 |
| Mailing Fax Number | 9719835211 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2019-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | 1049473 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225XH1200X |
Occupational Therapist Specialization: Hand |
1049473 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 297902 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2213 Country Club Rd, Woodburn, OR 970712811 | 5039824200 | 5039812323 |
| 1914 Willamette Falls Dr Ste 210, West Linn, OR 970684689 | 5036948366 | 5036948581 |
| Street Address |
8995 SW MILEY RD STE 109 |
| City | WILSONVILLE |
| State | OR |
| Zip Code | 97070-5485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326685157 | Crispin Counseling LLC | Clinic/Center | 8995 Sw Miley Rd Ste 109, Wilsonville, OR 97070-5485 | 2019-11-27 |
| 1023477700 | Lora Bea Smith | Occupational Therapist | 8995 Sw Miley Rd Ste 109, Wilsonville, OR 97070-5485 | 2016-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457995896 | Rosalyn Sharon Mckinney | Technician | 7798 Sw Vlahos Dr, Wilsonville, OR 97070 | 2019-10-29 |
| 1275027393 | Oregon Regeneration Stem Cell Medical Center, LLC | Chiropractor | 29781 Sw Town Center Loop, Wilsonville, OR 97070 | 2018-06-21 |
| 1073050472 | Kirstin Marie Lauritzen | Chiropractor | 25589 Sw Canyon Creek Rd Ste 100, Wilsonville, OR 97070 | 2017-01-23 |
| 1932642220 | Nicole Galasso | Occupational Therapy Assistant | 25117 Sw Parkway Avenue Suite D, Wilsonville, OR 97070 | 2016-11-18 |
| 1508317512 | Justin Langlais | Naturopath | 25195 Sw Parkway Ave Ste 210, Wilsonville, OR 97070 | 2016-10-14 |
| 1518411149 | Stephanie Tran | Optometrist | 29250 Town Center Loop W, Wilsonville, OR 97070 | 2016-08-11 |
| 1346610607 | Rachel Ziegler | Occupational Therapy Assistant | 25117 Sw Parkway Ave Suite D, Willsonville, OR 97070 | 2015-09-30 |
| 1992184238 | Michelle Miranda | Counselor | 30150 Sw Parkway Ave Ste 300, Wilsonville, OR 97070 | 2015-05-19 |
| 1609275007 | Ryan Bridges | Dentist | 30040 Sw Boones Ferry Rd Ste 20, Wilsonville, OR 97070 | 2014-08-21 |
| 1649604018 | Jason Russell James | Physical Therapist | 29174 Sw Town Center Loop W # 202b, Wilsonville, OR 97070 | 2013-08-21 |
| Find all providers in zip 97070 | ||||
| Taxonomy Code | 225XH1200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| Specialization | Hand |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639430887 | Carrie F. Meadowcroft | Occupational Therapist | 598 E. 13th Avenue, Eugene, OR 97401 | 2012-06-05 |
| 1861764003 | Sanders Hand Therapy, Inc | Occupational Therapist | 1914 Willamette Falls Dr Ste 210, West Linn, OR 97068-4689 | 2012-02-03 |
| 1033410709 | Marta Bogrand | Occupational Therapist | 2525 Nw Lovejoy St Ste 205, Portland, OR 97210-2863 | 2010-11-10 |
| 1962727545 | Willamette Hand Therapy, LLC | Occupational Therapist | 1711 Willamette St, Suite 302, Eugene, OR 97401-4014 | 2010-04-07 |
| 1235395252 | Jennifer Renee Allen | Occupational Therapist | 23070 Sw Lodgepole Ave, Tualatin, OR 97062-7609 | 2008-07-29 |
| 1477753291 | Rebound Physical Therapy, LLC | Occupational Therapist | 61470 S Highway 97, Suite 4, Bend, OR 97702-2187 | 2007-07-19 |
| 1225190994 | Hands On Upper Extremity Rehab LLC | Occupational Therapist | 17020 Sw Upper Boones Ferry Rd, Suite 102, Portland, OR 97224-7078 | 2006-12-15 |
| 1427128834 | Eugene Hand Therapy Clinic LLC | Occupational Therapist | 2866 Crescent Ave, Suite 107, Eugene, OR 97408-7342 | 2006-11-09 |
| 1700891165 | Ryan Douglas Glover Armworks Hand Therapy | Occupational Therapist | 11300 Ne Halsey St Ste 102, Portland, OR 97220-2013 | 2006-07-31 |
| 1881662914 | Janet Mary Sanders | Occupational Therapist | 2213 Country Club Rd, Woodburn, OR 97071-2811 | 2006-03-14 |
| Find all providers with the same taxonomy | ||||
| City | WILSONVILLE |
| Zip Code | 97070 |
Please comment or provide details below to improve the information on SHANNON RENAE WAKEM.
| 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.