Suzanna Shepherd

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO60656742 Issued in WA

Practice address

22026 20TH Ave SE Ste 101
Canyon Park Treatment Solutions
Bothell, WA 98021-4449

Phone

(425) 672-7293

Fax

(425) 329-4640

NPI assigned

Jul 11, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1780036004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22026 20TH AVE SE STE 101",
            "address_2": "CANYON PARK TREATMENT SOLUTIONS",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214449",
            "telephone_number": "425-672-7293",
            "fax_number": "425-329-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22026 20TH AVE SE STE 101",
            "address_2": "CANYON PARK TREATMENT SOLUTIONS",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214449",
            "telephone_number": "425-672-7293",
            "fax_number": "425-329-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "SUZANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "60656742",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60656742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CO60656742",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruchi Gupta Sharma, M.D.
• Peggy Jo Shaw
• Suzanne Marie Shay, D.C.
• Samuel Edward Shelton
• Shema Counseling and Coaching
• Shannon Sherman
• Zosia M.F. Sherwood, HS, AA, BS, CBT
• Emily Caroline Shields
• Maxine Shih, PT
• Victoria Shimotsu, M.D.

• Addiction (Substance Use Disorder) Counselor in Bothell, WA
• Providers in Bothell, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.