Provider Demographics
NPI:1013532274
Name:BARBER, SHELLEY M (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:M
Last Name:BARBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6408 20TH AVE NW APT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2373
Mailing Address - Country:US
Mailing Address - Phone:865-805-0425
Mailing Address - Fax:
Practice Address - Street 1:4126 E MADISON ST STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-3345
Practice Address - Country:US
Practice Address - Phone:206-926-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61060581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health