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General NPI Number Information
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NPI Number | 1396493441
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Entity Type | Individual
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Provider Name | SHARIF SHADI PSYD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 403 E MEEKER ST STE 200
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City | KENT
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State | WA
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Zip | 98030-5904
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Country | US
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Telephone | 253-852-2866
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Fax |
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Provider Business Mailing Address
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Address Line | 701 5TH AVE N
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City | SEATTLE
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State | WA
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Zip | 98109-5100
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Country | US
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Telephone | 646-290-1772
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071022308
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MC61286801
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY61505118
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License Number State | WA
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