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Individual
SHAWN W BOLEY
Active
Individual
SHAWN W BOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60209517
WA
1041C0700X
Clinical Social Worker
Primary
LW60787398
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2095718
—
WA
Enumeration date
11/29/2016
Last updated
02/17/2020
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