Provider Demographics
NPI:1528941549
Name:JAMES, SHAREESE (LMT)
Entity type:Individual
Prefix:MS
First Name:SHAREESE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7422 CASTOR AVE
Mailing Address - Street 2:PMB 5084
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149
Mailing Address - Country:US
Mailing Address - Phone:267-666-9872
Mailing Address - Fax:267-666-9872
Practice Address - Street 1:7422 CASTOR AVE
Practice Address - Street 2:PMB 5084
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149
Practice Address - Country:US
Practice Address - Phone:267-666-9872
Practice Address - Fax:267-666-9872
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMSG004421225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist