Provider Demographics
NPI:1053771956
Name:HEDQUIST, SHAWNA BRITTNEY (MA, NCC, LMHC)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:BRITTNEY
Last Name:HEDQUIST
Suffix:
Gender:F
Credentials:MA, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S JEFFERSON ST STE 114
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3100
Mailing Address - Country:US
Mailing Address - Phone:509-850-0662
Mailing Address - Fax:
Practice Address - Street 1:400 S JEFFERSON ST STE 114
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3100
Practice Address - Country:US
Practice Address - Phone:509-850-0662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60920043101YM0800X
WAMC60784973101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2114222Medicaid