Individual
JEFFREY ALLEN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY. D.
Contact information
Practice address
12303 NE 130TH LN, SUTIE 325, KIRKLAND, WA 98034-3099
(425) 899-3140
(425) 899-3131
Mailing address
PO BOX 34036, SEATTLE, WA 98124-1036
(425) 899-3292
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PY00002441
WA
103TA0700X
Adult Development & Aging Psychologist
PY00002441
WA
103TB0200X
Cognitive & Behavioral Psychologist
PY00002441
WA
103TC0700X
Clinical Psychologist
Primary
PY00002441
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8372013
—
WA
Enumeration date
01/17/2007
Last updated
10/14/2010
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