Provider Demographics
NPI:1447925482
Name:VOS, LAURA GRACE (MHCAL)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:GRACE
Last Name:VOS
Suffix:
Gender:F
Credentials:MHCAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19515 N CREEK PKWY STE 306
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8200
Mailing Address - Country:US
Mailing Address - Phone:425-298-6137
Mailing Address - Fax:
Practice Address - Street 1:19515 N CREEK PKWY STE 306
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8200
Practice Address - Country:US
Practice Address - Phone:425-298-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61109323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health