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NPI Code Detail

MEDICARE: DR. ALLISON NICOLE SHIELDS PHD

MEDICARE: DR. ALLISON NICOLE SHIELDS PHD
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
1103TC0700XClinical PsychologistPSYC.PY.61657389WA

General Provider Information

NPI Number : 1558226878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLISON NICOLE SHIELDS PHD
Provider Business Mailing Address
First Line : 216 E ROANOKE ST APT A
Second Line :
City : SEATTLE
State : WA
Zip : 98102-3233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4800 SAND POINT WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-3901
Country : US
Telephone Number : 206-987-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2025
Last Update Date : 12/18/2025

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