Provider Demographics
NPI:1770539686
Name:MCKEE, SHANNON H (MSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:H
Last Name:MCKEE
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 1:10049 KITSAP MALL BLVD NW
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8903
Mailing Address - Country:US
Mailing Address - Phone:360-307-8700
Mailing Address - Fax:360-692-6458
Practice Address - Street 1:10049 KITSAP MALL BLVD NW
Practice Address - Street 2:SUITE 203
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8903
Practice Address - Country:US
Practice Address - Phone:360-307-8700
Practice Address - Fax:360-692-6458
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000087401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8863448Medicare PIN