Healthcare Provider Details

I. General information

NPI: 1831372010
Provider Name (Legal Business Name): KERRI B SHOUMAKER LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13501 MANZANITA RD NE
BAINBRIDGE ISLAND WA
98110-4240
US

IV. Provider business mailing address

13501 MANZANITA RD NE
BAINBRIDGE ISLAND WA
98110-4240
US

V. Phone/Fax

Practice location:
  • Phone: 480-707-8686
  • Fax:
Mailing address:
  • Phone: 480-707-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61576206
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: