Provider Demographics
NPI:1942506464
Name:SHIRK, DAVID P (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:SHIRK
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:12740 33RD AVE NE
Practice Address - Street 2:MCDERMOTT PLACE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6581
Practice Address - Country:US
Practice Address - Phone:206-302-2891
Practice Address - Fax:206-302-2885
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW603496061041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker