Provider Demographics
NPI:1841864477
Name:SHANNON TAIT, LMFT, PLLC
Entity type:Organization
Organization Name:SHANNON TAIT, LMFT, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:TAIT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:206-880-3961
Mailing Address - Street 1:16150 NE 85TH ST STE 222B
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3546
Mailing Address - Country:US
Mailing Address - Phone:206-880-3961
Mailing Address - Fax:425-636-8753
Practice Address - Street 1:16150 NE 85TH ST STE 222B
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3546
Practice Address - Country:US
Practice Address - Phone:206-880-3961
Practice Address - Fax:425-636-8753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty