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NPI Code Detail

MEDICARE: ELIZABETH HOWE SHAW

MEDICARE:   ELIZABETH HOWE SHAW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101Y00000XCounselorMC70002227WA
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1104665090
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH HOWE SHAW
Provider Business Mailing Address
First Line : 955 POWELL AVE SW
Second Line :
City : RENTON
State : WA
Zip : 98057-2908
Country : US
Telephone Number : 425-277-1311
Fax Number : 425-277-1566
Provider Business Practice Location Address
First Line : 13030 MILITARY RD S STE 200
Second Line :
City : TUKWILA
State : WA
Zip : 98168-3001
Country : US
Telephone Number : 206-439-3289
Fax Number : 206-439-3273
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2024
Last Update Date : 01/09/2026

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