Provider Demographics
NPI:1649004748
Name:CREATIVE EXPRESSIONS PLLC
Entity type:Organization
Organization Name:CREATIVE EXPRESSIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KANALY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:206-717-4884
Mailing Address - Street 1:409 N 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6401
Mailing Address - Country:US
Mailing Address - Phone:206-717-4884
Mailing Address - Fax:
Practice Address - Street 1:409 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6401
Practice Address - Country:US
Practice Address - Phone:206-717-4884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty