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Beau D Shattuck
Peer Specialist in Lacey, Washington
NPI 1710658547

Beau D Shattuck is a Peer Specialist based in Lacey, WA. Beau D Shattuck practices in Lacey, WA. The NPI Number for Beau D Shattuck is 1710658547 and holds a License No. (Washington).

The current practice location address for Beau D Shattuck is 612 Woodland Square Loop Se Ste 401, Lacey, WA and can be reached out via phone at 360-763-5828. You can also correspond with Beau D Shattuck through the mailing address at 612 WOODLAND SQUARE LOOP SE STE 401, LACEY, WA - 98503-1070 (mailing address contact number: 360-763-5796).

Location: 612 Woodland Square Loop Se Ste 401, Lacey, WA, 98503-1070
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710658547
Provider Name
Beau D Shattuck
Credential
Provider Entity Type
Individual
Gender
Male
Address
612 Woodland Square Loop Se Ste 401, Lacey, WA, 98503-1070
Phone Number
360-763-5828
Fax Number
Provider Enumeration Date
09/22/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
612 Woodland Square Loop Se Ste 401
City
Lacey
State
Washington
Zip
98503-1070
Phone Number
360-763-5828
Fax Number
person
Provider Business Mailing Address Details
Address
612 Woodland Square Loop Se Ste 401
City
Lacey
State
Washington
Zip
98503-1070
Phone Number
360-763-5828
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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