Individual
JUSTIN KOOISTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 E FAIRHAVEN AVE, BURLINGTON, WA 98233-1914
(360) 856-3054
(360) 856-3065
Mailing address
1133 RAILROAD AVE STE 100, BELLINGHAM, WA 98225-5054
(360) 676-2164
(360) 676-2144
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SC61454368
WA
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/19/2017
Last updated
04/03/2025
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