Individual
SUZANNA SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22026 20TH AVE SE STE 101, CANYON PARK TREATMENT SOLUTIONS, BOTHELL, WA 98021-4449
(425) 672-7293
(425) 329-4640
Mailing address
22026 20TH AVE SE STE 101, CANYON PARK TREATMENT SOLUTIONS, BOTHELL, WA 98021-4449
(425) 672-7293
(425) 329-4640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60656742
WA
390200000X
Student in an Organized Health Care Education/Training Program
60656742
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CO60656742
—
WA
Enumeration date
07/11/2016
Last updated
04/04/2017
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