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General NPI Number Information
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NPI Number | 1972658243
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Entity Type | Individual
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Provider Name | SHELLEY SMITH HADDOW MSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12233 116TH AVE NE SUITE 102
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City | KIRKLAND
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State | WA
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Zip | 98034-6911
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Country | US
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Telephone | 425-823-5793
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 NE 95TH ST
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City | SEATTLE
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State | WA
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Zip | 98115-2220
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Country | US
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Telephone | 425-823-5793
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW00004793
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License Number State | WA
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