Provider Demographics
NPI:1407909054
Name:MORGAN, B. SHELLY (ARNP, PSYD)
Entity Type:Individual
Prefix:
First Name:B. SHELLY
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:ARNP, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 ROOSEVELT WAY NE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2252
Mailing Address - Country:US
Mailing Address - Phone:206-913-3161
Mailing Address - Fax:
Practice Address - Street 1:9500 ROOSEVELT WAY NE
Practice Address - Street 2:SUITE 206
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2252
Practice Address - Country:US
Practice Address - Phone:206-913-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006745103TC0700X
WARN00141657363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health