Provider Demographics
NPI:1700956968
Name:SHIFFMAN, AUDREY LYNN (MSW)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:LYNN
Last Name:SHIFFMAN
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 1:4519 CALIFORNIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4110
Mailing Address - Country:US
Mailing Address - Phone:206-937-0507
Mailing Address - Fax:206-236-4782
Practice Address - Street 1:4519 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4110
Practice Address - Country:US
Practice Address - Phone:206-937-0507
Practice Address - Fax:206-236-4782
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000054601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical