Provider Demographics
NPI:1568530905
Name:BONNEY, SHIRLEY JANE (MSW)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:JANE
Last Name:BONNEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 WESTERN AVE
Mailing Address - Street 2:SUITE 603
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1563
Mailing Address - Country:US
Mailing Address - Phone:206-264-5001
Mailing Address - Fax:
Practice Address - Street 1:1507 WESTERN AVE
Practice Address - Street 2:SUITE 603
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1563
Practice Address - Country:US
Practice Address - Phone:206-264-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical