Shane Aaron Van Fossen, CO70013818
Shane Aaron Van Fossen, CO70013818 is an Addiction (Substance Use Disorder) Counselor in Kelso, Washington. Practices as a sole proprietor. Licensed in Washington.
- Licensed in
- WA
- In the registry since
- 2025
Practice location Address checks out
305 Pacific Ave S Ste CKelso, WA 98626-1638
Phone: (360) 356-7761
Fax: (360) 219-6843
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence CO70013818 (WA) |
|---|
Record details
| NPI number | 1922986850 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | CO70013818 |
| Sole proprietor | Yes |
| NPI enumerated | August 27, 2025 |
| Last updated in NPPES | August 27, 2025 |
| Certification date | August 27, 2025 |
Other providers in Kelso
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Deborah Smith
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Shauna Sprague, SUDP-T
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Mrs. Mindy Lorraine Taitano
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Mr. Larry James Tedder, CDP
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Mr. Paul Allen Welk, AS, CDP
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Stacy Raeann Wirkkala, SUDPT
404 W Main St, Kelso, WA 98626-1118 · (360) 423-2806
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MS. Sydney J Wolfe
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