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General NPI Number Information
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NPI Number | 1790512879
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Entity Type | Individual
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Provider Name | SHANNONDOA BAUGH
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Gender |
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 7440 W MARGINAL WAY S
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City | SEATTLE
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State | WA
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Zip | 98108-4141
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Country | US
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Telephone | 206-772-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 735 7TH ST SE APT 215
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City | PUYALLUP
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State | WA
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Zip | 98372-3817
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Country | US
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Telephone | 206-717-1635
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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