Healthcare Provider Details

I. General information

NPI: 1952440281
Provider Name (Legal Business Name): SHELLAH MYRA IMPERIO PH. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 W MARINE VIEW DR
EVERETT WA
98201-2094
US

IV. Provider business mailing address

7600 EVERGREEN WAY
EVERETT WA
98203-6421
US

V. Phone/Fax

Practice location:
  • Phone: 425-339-5453
  • Fax:
Mailing address:
  • Phone: 206-860-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY60084605
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: