Individual
KERRY ANN SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6424 N 9TH ST, TACOMA, WA 98406-2091
(253) 565-4484
(253) 565-5823
Mailing address
6424 N 9TH ST, TACOMA, WA 98406-2091
(253) 565-4484
(253) 565-5823
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
60599869
WA
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60599869
SOCIAL WORKER INDEPENDENT CLINICAL LICENSE
WA
Enumeration date
11/26/2019
Last updated
12/03/2021
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