Provider Demographics
NPI:1568660330
Name:ARNASON, SAM RUSSELL (BA, CDP)
Entity Type:Individual
Prefix:MR
First Name:SAM
Middle Name:RUSSELL
Last Name:ARNASON
Suffix:
Gender:M
Credentials:BA, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 N GARDEN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5429
Mailing Address - Country:US
Mailing Address - Phone:360-305-4847
Mailing Address - Fax:
Practice Address - Street 1:4455 CORDATA PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8037
Practice Address - Country:US
Practice Address - Phone:360-734-5458
Practice Address - Fax:360-734-5298
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00053261101Y00000X
WACP00006219101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)