MISS RESA SHANER (PA-C) – Physician Assistant, NPI 1619964186
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,282 PHYSICIAN ASSISTANT in WA
Provider Addresses for MISS RESA SHANER (PA-C)
939 MT VIEW DR
SUITE 100
SHELTON, WA 985844410
Phone: (360) 426-2653
Fax: (360) 427-7086
Type: Mailing
PO BOX 1668
SHELTON, WA 985845001
Phone: (360) 427-9549
Fax: (360) 427-7086
Type: Mailing
1701 N 13TH ST STE 100
SHELTON, WA 985842077
Phone: (360) 426-2653
Fax: (360) 427-7086
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-02-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040329001802 | I | Physician Assistant | WA | TBD |
| I20250225003130 | I | Physician Assistant | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98584)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IN | |
| Internal Medicine | WA | |
| Internal Medicine | IA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | IL |
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