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Individual

MS. SHANNON RAE CANTRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SUDP

Contact information

Practice address
19045 STATE HIGHWAY 305 NE STE 190, POULSBO, WA 98370-7312
(360) 876-9430
(360) 598-4114
Mailing address
19045 STATE HIGHWAY 305 NE STE 190, POULSBO, WA 98370-7312
(360) 876-9430
(360) 598-4114

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60724206
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60938713
WA

Other

Enumeration date
10/31/2018
Last updated
04/15/2026
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