Provider Demographics
NPI:1336967496
Name:SHIPMAN, LAINEY FELICE (LMT)
Entity type:Individual
Prefix:
First Name:LAINEY
Middle Name:FELICE
Last Name:SHIPMAN
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:LAINEY
Other - Middle Name:FELICE
Other - Last Name:MCMINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:35683 AVA RD
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-8489
Mailing Address - Country:US
Mailing Address - Phone:971-601-0411
Mailing Address - Fax:
Practice Address - Street 1:10 PIER 1 STE 308
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-6338
Practice Address - Country:US
Practice Address - Phone:503-974-0914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist