Provider Demographics
NPI:1417584129
Name:SHAFTO, LINDSEY MARIE
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:SHAFTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 HOLMAN RD NW STE 4
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3481
Mailing Address - Country:US
Mailing Address - Phone:925-207-9949
Mailing Address - Fax:
Practice Address - Street 1:9015 HOLMAN RD NW STE 4
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3481
Practice Address - Country:US
Practice Address - Phone:206-553-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60929780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health