Active NPI
Vanessa Evelyn Soderberg, M.S. L.M.F.T.
- Marriage & Family Therapist
- Camano Island, WA
National Provider Identifier
1619099751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LF00000966
- Practice address
- 453 House PL
Camano Island, WA 98282-8579 - Phone
- (360) 387-5136
- Fax
- (360) 387-1644
- NPI assigned
- Apr 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LF00000966 | WA | Primary |
Addresses
Primary practice location
453 House PL
Camano Island, WA 98282-8579
Mailing address
PO Box 2646
Stanwood, WA 98292-2646
Phone (360) 387-5136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LF00000966 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619099751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2646",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982922646",
"telephone_number": "360-387-5136",
"fax_number": "360-387-1604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 HOUSE PL",
"city": "CAMANO ISLAND",
"state": "WA",
"postal_code": "982828579",
"telephone_number": "360-387-5136",
"fax_number": "360-387-1644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SODERBERG",
"first_name": "VANESSA",
"middle_name": "EVELYN",
"name_prefix": "Ms.",
"credential": "M.S. L.M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF00000966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Camano Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.