Individual
DR. JOHN LEWIS SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3331 BROADWAY, EVERETT, WA 98201-4472
(360) 321-1022
(360) 321-4575
Mailing address
PO BOX 744, FREELAND, WA 98249-0744
(360) 321-1022
(360) 321-4575
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00000580
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017234
WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRIES
WA
01
—
PY00000580
PROFESSIONAL LICENSE
WA
Enumeration date
06/16/2006
Last updated
04/16/2012
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