Provider Demographics
NPI:1265792709
Name:CROYDON-SHEA, NATASHA JADE
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:JADE
Last Name:CROYDON-SHEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4245 ROOSEVELT WAY NE
Mailing Address - Street 2:BOX 354740
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6008
Mailing Address - Country:US
Mailing Address - Phone:206-598-6716
Mailing Address - Fax:206-598-1073
Practice Address - Street 1:4245 ROOSEVELT WAY NE
Practice Address - Street 2:BOX 354740
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6008
Practice Address - Country:US
Practice Address - Phone:206-598-6716
Practice Address - Fax:206-598-1073
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator