Individual
MS. BONITA SHUFFAIN SIEGEL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
15029 BOTHELL WAY NE, SUITE 300, LAKE FOREST PARK, WA 98155-7663
(206) 364-0075
(206) 364-7607
Mailing address
15029 BOTHELL WAY NE, SUITE 300, LAKE FOREST PARK, WA 98155-7663
(206) 364-0075
(206) 364-7607
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LW00004023
SOCIAL WORKER LICENSE #
WA
Enumeration date
11/15/2005
Last updated
07/08/2007
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