Provider Demographics
NPI:1073653697
Name:SHECTER, NINA F (PHD)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:F
Last Name:SHECTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6139 TIGER TAIL DR SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-2137
Mailing Address - Country:US
Mailing Address - Phone:360-250-8422
Mailing Address - Fax:360-628-8565
Practice Address - Street 1:677 WOODLAND SQUARE LOOP SE # B3
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1000
Practice Address - Country:US
Practice Address - Phone:360-250-8422
Practice Address - Fax:360-628-8565
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00003563103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist