Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Aaron Van Fossen, CO70013818

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1922986850

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 C
Kelso, WA 98626-1638
Phone: (360) 356-7761
Fax: (360) 219-6843
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CO70013818 (WA)

Record details

NPI number1922986850
Entity typeIndividual (Type 1)
GenderMale
Credentials CO70013818
Sole proprietorYes
NPI enumeratedAugust 27, 2025
Last updated in NPPESAugust 27, 2025
Certification dateAugust 27, 2025

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