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General NPI Number Information
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NPI Number | 1982246500
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Entity Type | Organization
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Legal Business Name | SKY CIRCLES HEALING ARTS PLLC
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 1840 NW 202ND ST
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City | SHORELINE
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State | WA
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Zip | 98177-2247
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Country | US
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Telephone | 206-706-2932
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Fax |
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Provider Business Mailing Address
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Address Line | 20126 BALLINGER WAY NE # 274
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City | SHORELINE
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State | WA
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Zip | 98155-1117
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Country | US
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Telephone | 206-706-2932
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHANNON NICOLE BUDELMAN
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Credential |
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Telephone | 206-706-2932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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