Provider Demographics
NPI:1902372626
Name:KASHIMAWO, SHAKIRAT O
Entity Type:Individual
Prefix:
First Name:SHAKIRAT
Middle Name:O
Last Name:KASHIMAWO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHAKIRAT
Other - Middle Name:O
Other - Last Name:KASHIMAWO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHS
Mailing Address - Street 1:2600 SW HOLDEN ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3505
Mailing Address - Country:US
Mailing Address - Phone:206-933-7199
Mailing Address - Fax:206-933-7201
Practice Address - Street 1:2600 SW HOLDEN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3505
Practice Address - Country:US
Practice Address - Phone:206-933-7199
Practice Address - Fax:206-933-7201
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-20
Last Update Date:2018-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health