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General NPI Number Information
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NPI Number | 1174063051
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Entity Type | Individual
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Provider Name | CLAUDETTE V. SELKRIDGE MC60489858
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Gender | Female
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 1620 N. OLYMPIC HWY
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City | SHELTON
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State | WA
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Zip | 98584
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Country | US
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Telephone | 360-258-3400
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Fax | 360-930-6887
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Provider Business Mailing Address
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Address Line | P.O. BOX 366
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City | HOODSPORT
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State | WA
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Zip | 98548
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Country | US
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Telephone | 360-285-3400
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Fax | 360-930-6887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MC60489858
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC60489858
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License Number State | WA
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