Provider Demographics
NPI:1124441639
Name:SHIMADA, KATHERINE (MSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SHIMADA
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 1:8304 16TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3609
Mailing Address - Country:US
Mailing Address - Phone:206-601-0062
Mailing Address - Fax:
Practice Address - Street 1:1417 NW 54TH ST STE 304
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3573
Practice Address - Country:US
Practice Address - Phone:206-601-0062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW607556571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical