Provider Demographics
NPI:1891129318
Name:SHEMON, JOSHUA
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:SHEMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:GOSHU
Other - Middle Name:
Other - Last Name:SEMMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33438 1ST WAY S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6214
Mailing Address - Country:US
Mailing Address - Phone:206-824-9273
Mailing Address - Fax:253-392-2110
Practice Address - Street 1:33438 1ST WAY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6214
Practice Address - Country:US
Practice Address - Phone:206-824-9273
Practice Address - Fax:253-392-2110
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00002897101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)