Individual
MR. SHANE DAVID ISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
2415 WESTERN AVE APT 307, SEATTLE, WA 98121-1364
(206) 905-4660
(206) 577-1101
Mailing address
24 ROY ST # 434, SEATTLE, WA 98109-4018
(206) 905-4660
(206) 577-1101
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
60099445
WA
103K00000X
Behavior Analyst
Primary
1-08-4236
—
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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