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NPI Code Detail

MEDICARE: MS. JANET R SHELSTAD MA, LMFT

MEDICARE: MS. JANET R SHELSTAD MA, LMFT
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
1106H00000XMarriage & Family TherapistLF60071452WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2LF60071452WOTHERWAWA DOH

General Provider Information

NPI Number : 1538355722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANET R SHELSTAD MA, LMFT
Provider Business Mailing Address
First Line : 10116 36TH AVENUE CT SW
Second Line : 109
City : LAKEWOOD
State : WA
Zip : 98499-4791
Country : US
Telephone Number : 253-332-1030
Fax Number :
Provider Business Practice Location Address
First Line : 10116 36TH AVENUE CT SW
Second Line : 109
City : LAKEWOOD
State : WA
Zip : 98499-4791
Country : US
Telephone Number : 253-332-1030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2007
Last Update Date : 02/03/2017

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