Individual
MR. CARL HILTON VANOSDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
564 NE RAVENNA BLVD, SEATTLE, WA 98115-6460
(206) 527-2266
Mailing address
PO BOX 1003, KINGSTON, WA 98346-1003
(802) 272-4037
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0001021
VT
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00068055
BC/BS VT
VT
05
—
1010599
—
VT
01
—
2273134
CIGNA
VT
01
—
360324
TRICARE
VT
Enumeration date
07/05/2006
Last updated
06/06/2022
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