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General NPI Number Information
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NPI Number | 1891074159
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Entity Type | Individual
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Provider Name | SHANNON ALBERT PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 1455 NW LEARY WAY STE 400
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City | SEATTLE
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State | WA
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Zip | 98107-5138
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Country | US
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Telephone | 206-317-4397
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Fax |
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Provider Business Mailing Address
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Address Line | 522 W RIVERSIDE AVE STE N
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City | SPOKANE
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State | WA
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Zip | 99201-0581
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Country | US
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Telephone | 206-317-4397
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60546869
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License Number State | WA
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