Provider Demographics
NPI:1831165943
Name:SHIMENSKY, MICHAEL GARY (HEAD TRAINER)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:GARY
Last Name:SHIMENSKY
Suffix:
Gender:M
Credentials:HEAD TRAINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4631
Mailing Address - Country:US
Mailing Address - Phone:206-281-5846
Mailing Address - Fax:206-286-3347
Practice Address - Street 1:490 5TH AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4631
Practice Address - Country:US
Practice Address - Phone:206-281-5846
Practice Address - Fax:206-286-3347
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist