Provider Demographics
NPI:1316356595
Name:DONHAUSER, SHANNA (MSW)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:DONHAUSER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:
Other - Last Name:DULIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-0122
Mailing Address - Country:US
Mailing Address - Phone:206-683-2969
Mailing Address - Fax:
Practice Address - Street 1:5414 DELRIDGE WAY SW UNIT A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-1478
Practice Address - Country:US
Practice Address - Phone:360-813-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASW605567391041C0700X
WALW607771871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical