Provider Demographics
NPI:1154674570
Name:SHAWE, ELIZABETH (CMT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SHAWE
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13307 ELIZABETH CT
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2089
Mailing Address - Country:US
Mailing Address - Phone:303-902-0205
Mailing Address - Fax:
Practice Address - Street 1:13307 ELIZABETH CT
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2089
Practice Address - Country:US
Practice Address - Phone:303-902-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7556225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist