Provider Demographics
NPI:1407993900
Name:FREEMAN, SHANNON (DAC, DCEM, QIGONG)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:DAC, DCEM, QIGONG
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DAC, DCEM, QIGONG
Mailing Address - Street 1:1118 FINNEGAN WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6656
Mailing Address - Country:US
Mailing Address - Phone:360-366-4216
Mailing Address - Fax:360-366-4241
Practice Address - Street 1:1118 FINNEGAN WAY STE 103
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6656
Practice Address - Country:US
Practice Address - Phone:360-366-4216
Practice Address - Fax:360-366-4241
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60254073171100000X
WATAICHIQIGONGPROFF2255A2300X
WAMA12766225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND2019-01OtherACUPUNCTURE LICENSE
WANQAOtherTAI CHI/QIGONG PROFESSIONAL MEMBER
WA151841OtherNCCAOM MEMBER
WAAC60254073OtherWASHINGTON STATE
WANQAOtherQIGONG PROFESSIONAL MEMBER
WA1245656313OtherNPI NUMBER A BETTER WAY MASSAGE, LLC, BELLINGHAM, WA