Healthcare Provider Details

I. General information

NPI: 1730859703
Provider Name (Legal Business Name): CAITLYN HUSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULY HUSS

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9822 SW GORSUCH RD
VASHON WA
98070-4903
US

IV. Provider business mailing address

11010 SW 160TH ST
VASHON WA
98070-4151
US

V. Phone/Fax

Practice location:
  • Phone: 206-463-5502
  • Fax:
Mailing address:
  • Phone: 661-313-3921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: