Healthcare Provider Details

I. General information

NPI: 1982246500
Provider Name (Legal Business Name): SKY CIRCLES HEALING ARTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 12/22/2020
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 NW 202ND ST
SHORELINE WA
98177-2247
US

IV. Provider business mailing address

20126 BALLINGER WAY NE # 274
SHORELINE WA
98155-1117
US

V. Phone/Fax

Practice location:
  • Phone: 206-706-2932
  • Fax:
Mailing address:
  • Phone: 206-706-2932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANNON NICOLE BUDELMAN
Title or Position: OWNER
Credential:
Phone: 206-706-2932