Healthcare Provider Details

I. General information

NPI: 1093280497
Provider Name (Legal Business Name): SHELBY LYNN BUCHANAN BA, MHP, GMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 S JACKSON ST
SEATTLE WA
98144-2591
US

IV. Provider business mailing address

2212 S JACKSON ST
SEATTLE WA
98144-2591
US

V. Phone/Fax

Practice location:
  • Phone: 206-362-0560
  • Fax: 206-362-1470
Mailing address:
  • Phone: 206-206-3222
  • Fax: 206-362-1470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCU61534696
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG60566864
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: