Cameron Wan

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61423896 Issued in WA

Practice address

1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509

Phone

(360) 209-3792

NPI assigned

May 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Real Life Community Behavioral Health PLLC

  • Mental Health Counselor
  • Vancouver, WA
  • NPI 1952063265
  NPD (past)

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1730762865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835509",
            "telephone_number": "360-209-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835509",
            "telephone_number": "360-209-3792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 NE Oak View Dr",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986626157",
            "country_code": "US",
            "telephone_number": "360-567-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAN",
        "first_name": "CAMERON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61423896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nels Walther, DMD
• Victoria Jean Walz, R.N.
• Rose Wambold, CNA
• Geoffrey Severin Wampach, BS
• Alison M Wan, PA-C
• Yuquan Wan
• Rohan Wanchu, MD
• Amy Wang, D.O.
• Anton Wang, PHARMD
• Bei Wang, M.D.

• Mental Health Counselor in Vancouver, WA
• Providers in Vancouver, 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 Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.