MEDICARE: FYS PSYCHOTHERAPY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1881522860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FYS PSYCHOTHERAPY PLLC

Provider Business Mailing Address
First Line	:	1313 E MAPLE ST STE 223
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-5708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 E MAPLE ST STE 223
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-5708
Country	:	US
Telephone Number	:	206-580-3423
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANNE JANE VLOSSAK
Credential	:	LICSW
Telephone Number	:	503-580-4505

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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