Individual
MS. SHANNON DENEICE LEDESMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-1894
(253) 968-5125
Mailing address
9040-A JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3517
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY00002517
WA
103TH0004X
Health Psychologist
Primary
2517
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7574JO
REGENCE
WA
Enumeration date
06/01/2006
Last updated
06/10/2024
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