Provider Demographics
NPI:1407944226
Name:SHEPARD, JAMES (MSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:SHEPARD
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9818 5TH AVE NE APT 2C
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2154
Mailing Address - Country:US
Mailing Address - Phone:206-769-6695
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY # S-182-SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-277-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker