Doctor Name: | SHANNON C KING |
NPI Number: | 1306000328 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LMHC |
License Number: | LH00011178 |
Business Practice Address: | 918 Alder Ave Sumner, WA - 983901406 |
Business Phone Number: | 2532273222 |
Business Fax Number: | 2538911044 |
Mailing Address: | 918 Alder Ave, SUMNER |
State: | WA |
Postal Code: | 983901406 |
Phone Number: | 2532273222 |
Fax Number: | 2538911044 |
NPI Enumeration Date: | 07/18/2008 |
NPI Last Update Date: | 05/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00011178 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |