Provider Demographics
NPI:1750840906
Name:COTTON, SHANNON MICHELE (MSW)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:MICHELE
Last Name:COTTON
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 1:8820 NESBIT AVE N APT 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4084
Mailing Address - Country:US
Mailing Address - Phone:206-931-0354
Mailing Address - Fax:206-325-6516
Practice Address - Street 1:502 RAINIER AVE S STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-1912
Practice Address - Country:US
Practice Address - Phone:206-325-6515
Practice Address - Fax:206-325-6516
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker