Vanessa Evelyn Soderberg, M.S. L.M.F.T.

Individual provider Active NPI Marriage & Family Therapist · Camano Island, WA

NPI 1619099751 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619099751
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LF00000966 (WA)
Practice address
453 House PL
Camano Island, WA 98282-8579
Phone
(360) 387-5136
Fax
(360) 387-1644
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LF00000966WAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF00000966 WA Yes

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

Other providers in Camano Island, WA

All providers in Camano Island, WA · Marriage & Family Therapist in Washington

Sources for this page

Verify at the official NPI Registry.