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General NPI Number Information
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NPI Number | 1851715783
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Entity Type | Individual
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Provider Name | SHANNON SOLIE LMHCA
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Gender | Female
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 4221 9TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-6006
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Country | US
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Telephone | 206-859-7904
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Fax |
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Provider Business Mailing Address
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Address Line | 226 SUMMIT AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-5619
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Country | US
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Telephone | 206-456-6133
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | MC60411478
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License Number State | WA
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