Pamela Rose Vanderdoes, M.DIV, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

60853457 Issued in WA

Practice address

31507 106TH PL SE Apt S107
Auburn, WA 98092-3089

Phone

(208) 755-6121

Fax

(888) 884-6423

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588464000000",
    "number": "1184767600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31507 106TH PL SE APT S107",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980923089",
            "telephone_number": "208-755-6121",
            "fax_number": "888-884-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31507 106TH PL SE APT S107",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980923089",
            "telephone_number": "208-755-6121",
            "fax_number": "888-884-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERDOES",
        "first_name": "PAMELA",
        "middle_name": "ROSE",
        "credential": "M.DIV, MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-05-03",
        "certification_date": "2020-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "60853457",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-3236",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Auburn, WA
• Providers in Auburn, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.