Provider Demographics
NPI:1952472649
Name:MCNABB, AARON DOUGLAS (MS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:DOUGLAS
Last Name:MCNABB
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 11TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2555
Mailing Address - Country:US
Mailing Address - Phone:360-414-8600
Mailing Address - Fax:360-636-7372
Practice Address - Street 1:9300 NE OAK VIEW DR STE B
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6157
Practice Address - Country:US
Practice Address - Phone:360-751-6731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00049825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WATAX IDOther91-1854138
WAREGISTERED COUNSELOROtherRC00049825
WAL & I CRIME VICTIMSOther8940693