Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | PY00000752 | WA |
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PY00000752 | WA |
NPI | 1063690097 |
---|---|
Provider Name | Dr. Joyce Shaffer |
First Address | Bellevue, WA 98009-0765 |
Second Address | Bellevue, WA 98004-5459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 01/02/2008 |