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General NPI Number Information
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NPI Number | 1326233495
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Entity Type | Individual
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Provider Name | ELIZABETH SHIELDS M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 620 KIRKLAND WAY SUITE 200
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City | KIRKLAND
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State | WA
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Zip | 98033-6021
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Country | US
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Telephone | 206-550-7320
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Fax | 425-889-9401
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Provider Business Mailing Address
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Address Line | 9520 8TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-2117
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Country | US
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Telephone | 206-550-7320
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Fax | 425-889-9401
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH00008647
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License Number State | WA
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