Provider Demographics
NPI:1548317241
Name:SHOBE, JOHN LESLIE (LMFT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LESLIE
Last Name:SHOBE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 HARBORVIEW DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-2100
Mailing Address - Country:US
Mailing Address - Phone:253-857-4812
Mailing Address - Fax:253-857-4814
Practice Address - Street 1:3417 HARBORVIEW DR
Practice Address - Street 2:SUITE 104
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-2100
Practice Address - Country:US
Practice Address - Phone:253-857-4812
Practice Address - Fax:253-857-4814
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001815106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist