Provider Demographics
NPI:1184310849
Name:VAN DER HORST, JOHN WILLIAM
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:VAN DER HORST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 COWGILL AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7612
Mailing Address - Country:US
Mailing Address - Phone:360-850-9834
Mailing Address - Fax:
Practice Address - Street 1:2810 COWGILL AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7612
Practice Address - Country:US
Practice Address - Phone:360-850-9834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor