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Individual
SHANE WILLIAM ROSSOW
Active
Individual
SHANE WILLIAM ROSSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT, MA, LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60283751
WA
101YM0800X
Mental Health Counselor
Primary
MC60247370
WA
Other
Enumeration date
11/02/2012
Last updated
04/19/2013
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