SHANE AARON VAN FOSSEN

KELSO, WA
NPI1922986850
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO70013818)
Enumeration Date2025-08-27
Last Update Date2025-08-27
Business Address
SHANE AARON VAN FOSSEN CO70013818
305 PACIFIC AVE S STE C
KELSO, WA 98626-1638
Phone number: 360-356-7761
Mailing Address
SHANE AARON VAN FOSSEN CO70013818
305 PACIFIC AVE S STE C
KELSO, WA 98626-1638
Phone number: 360-356-7761
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