Provider Demographics
NPI:1548582281
Name:SHUTES, ERICA ANNE (LMFT, MA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ANNE
Last Name:SHUTES
Suffix:
Gender:F
Credentials:LMFT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 N 107TH ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-1305
Mailing Address - Country:US
Mailing Address - Phone:206-467-5027
Mailing Address - Fax:
Practice Address - Street 1:2150 N 107TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-1305
Practice Address - Country:US
Practice Address - Phone:206-467-5027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC60067393101YM0800X
WALF60297965106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health