Provider Demographics
NPI:1851756795
Name:SHOOK, MARCELLA (MSW)
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:
Last Name:SHOOK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MARCELLA
Other - Middle Name:
Other - Last Name:STARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:9300 NE OAK VIEW DR STE B
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6157
Mailing Address - Country:US
Mailing Address - Phone:360-567-2211
Mailing Address - Fax:
Practice Address - Street 1:9300 NE OAK VIEW DR STE B
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6157
Practice Address - Country:US
Practice Address - Phone:360-567-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-18
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker