Provider Demographics
NPI:1033726385
Name:PALMER, SHAWNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHAWNA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4957 LAKEMONT BLVD SE # C4-223
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-7801
Mailing Address - Country:US
Mailing Address - Phone:425-503-8685
Mailing Address - Fax:
Practice Address - Street 1:16450 SE 48TH PL
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-5820
Practice Address - Country:US
Practice Address - Phone:425-503-8685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist