Provider Demographics
NPI:1548909922
Name:MCSHANE, ZAY AIDAN SMITH
Entity type:Individual
Prefix:
First Name:ZAY
Middle Name:AIDAN SMITH
Last Name:MCSHANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 FLORA ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4430
Mailing Address - Country:US
Mailing Address - Phone:360-671-5898
Mailing Address - Fax:360-922-0648
Practice Address - Street 1:305 FLORA ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4430
Practice Address - Country:US
Practice Address - Phone:360-671-5898
Practice Address - Fax:360-922-0648
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator