Provider Demographics
NPI:1457720419
Name:PRICE, SHANNON ANNEKE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:ANNEKE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23515 NE NOVELTY HILL RD # B221-342
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-1996
Mailing Address - Country:US
Mailing Address - Phone:206-795-1960
Mailing Address - Fax:425-409-6618
Practice Address - Street 1:23515 NE NOVELTY HILL RD # B221-342
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-1996
Practice Address - Country:US
Practice Address - Phone:206-795-1960
Practice Address - Fax:425-968-0601
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALF60211272106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health