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Individual
SHILOH SHANE DALTON
Active
Individual
SHILOH SHANE DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP.CP.61666763
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO61151332
WA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO61151332
SUDP LICENSE
WA
01
—
CPD.CP.61666763
SUDP
WA
Enumeration date
07/29/2020
Last updated
07/07/2026
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