MEDICARE: SHANA CANTONI PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP30006360	WA
2	363L00000X	Nurse Practitioner	AP30006360	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	63993U	OTHER	WA	REGENCE BLUE SHIELD PIN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0168701	OTHER	WA	L&I PIN

General Provider Information

NPI Number	:	1366473142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA CANTONI PMHNP

Provider Business Mailing Address
First Line	:	753 N. 35TH STREET SUITE 208D
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8860
Country	:	US
Telephone Number	:	206-922-8414
Fax Number	:	845-302-8822

Provider Business Practice Location Address
First Line	:	753 N. 35TH STREET SUITE 208D
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8860
Country	:	US
Telephone Number	:	206-922-8414
Fax Number	:	845-302-8822

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	04/17/2026

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Directions to “ SHANA CANTONI PMHNP” Practice Location

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