Individual provider · Type 1 NPI

Shane Aaron Van Fossen, CO70013818

Addiction (Substance Use Disorder) Counselor · Kelso, WA

NPI number 1922986850 Active

Practice location

305 Pacific Ave S Ste C
Kelso, WA 98626-1638

Call (360) 356-7761 Map

Fax (360) 219-6843

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCO70013818 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1922986850

Shane Aaron Van Fossen, CO70013818's National Provider Identifier is 1922986850, issued on Aug 27, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Kelso, WA. The record was last updated on Aug 27, 2025.