Provider Demographics
NPI:1275254401
Name:SHJERVEN, SVETLANA ALEKSANDRA (LSWAIC)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:ALEKSANDRA
Last Name:SHJERVEN
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5706
Mailing Address - Country:US
Mailing Address - Phone:253-649-6010
Mailing Address - Fax:
Practice Address - Street 1:506 2ND AVE UNIT 1417
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2343
Practice Address - Country:US
Practice Address - Phone:253-649-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC613481331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical