Provider Demographics
NPI:1699172320
Name:GILIO-TENAN, SHANYN (LICSW)
Entity type:Individual
Prefix:
First Name:SHANYN
Middle Name:
Last Name:GILIO-TENAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14652 21ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1606
Mailing Address - Country:US
Mailing Address - Phone:541-517-1942
Mailing Address - Fax:
Practice Address - Street 1:2600 SW BARTON ST STE A24
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3993
Practice Address - Country:US
Practice Address - Phone:541-517-1942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA47-23941671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical