Shane Aaron Van Fossen, CO70013818
NPI #1922986850 in Kelso, Washington
Provider Information
- NPI Number
- 1922986850
- Entity Type
- Individual
- Name
- Shane Aaron Van Fossen, CO70013818
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- CO70013818
- Enumeration Date
- Aug 27, 2025
- Last Updated
- Aug 27, 2025
Practice Location
- Address
- 305 PACIFIC AVE S STE C
- City
- Kelso
- State
- Washington
- ZIP Code
- 98626-1638
- Phone
- (360) 356-7761
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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