Provider Demographics
NPI:1629517388
Name:SHERA LOONEY
Entity Type:Organization
Organization Name:SHERA LOONEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED BEHAVIOR TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHERA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-822-0101
Mailing Address - Street 1:500 5TH AVE W
Mailing Address - Street 2:502
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3957
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 5TH AVE W
Practice Address - Street 2:502
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3957
Practice Address - Country:US
Practice Address - Phone:404-822-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization