Provider Demographics
NPI:1336573328
Name:REESE, SHAEANN (MA)
Entity type:Individual
Prefix:
First Name:SHAEANN
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 W MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2172
Mailing Address - Country:US
Mailing Address - Phone:360-995-9736
Mailing Address - Fax:360-785-2042
Practice Address - Street 1:809 W MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2172
Practice Address - Country:US
Practice Address - Phone:360-995-9736
Practice Address - Fax:360-785-2042
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60522274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health