Healthcare Provider Details

I. General information

NPI: 1154036531
Provider Name (Legal Business Name): SHAYNA KAY GAMBS SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAYNA KAY WILLIAMSON SOCIAL WORKER

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 HARVEY RD NE STE C
AUBURN WA
98002-4294
US

IV. Provider business mailing address

921 HARVEY RD NE STE C
AUBURN WA
98002-4294
US

V. Phone/Fax

Practice location:
  • Phone: 253-939-2211
  • Fax: 253-939-2867
Mailing address:
  • Phone: 253-939-2211
  • Fax: 253-939-2867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCG61381389
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: