Provider Demographics
NPI:1679042220
Name:VOSS, JAMES ANDREW (MC60897375)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:VOSS
Suffix:
Gender:M
Credentials:MC60897375
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14016 5TH PL W
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6821
Mailing Address - Country:US
Mailing Address - Phone:425-647-3699
Mailing Address - Fax:
Practice Address - Street 1:1417 NW 54TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3570
Practice Address - Country:US
Practice Address - Phone:425-647-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60897375101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty