Provider Demographics
NPI:1457420200
Name:SHILLING, NINA EVELYN (MSW)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:EVELYN
Last Name:SHILLING
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 4TH AVENUE
Mailing Address - Street 2:APARTMENT 2703
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1470
Mailing Address - Country:US
Mailing Address - Phone:206-906-9530
Mailing Address - Fax:
Practice Address - Street 1:2025 1ST AVE
Practice Address - Street 2:SUITE 720
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1470
Practice Address - Country:US
Practice Address - Phone:206-849-4024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 60062985104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2473750OtherOXFORD PROVIDER ID
NO2781Medicare ID - Type Unspecified