Individual
DR. EKATERINA VLADIMIROVNA SHKURKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, MSW, LCSW
Contact information
Practice address
677 WOODLAND SQUARE LOOP SE, LACEY, WA 98503-1000
(360) 789-6248
Mailing address
3811 HAWTHORNE ST SE, OLYMPIA, WA 98501-4123
(360) 789-6248
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00005230
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8934628
MEDICARE PTAN
WA
Enumeration date
03/15/2013
Last updated
07/09/2015
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