Fredericksen, Gary J
Fredericksen, Gary J is an sole proprietor health care provider with primary practice located at 4422 6Th Ave Se , Lacey WA 98503-1020. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Fredericksen, Gary J can be contacted via phone (360) 704-7170.Contact Information
Primary practice address
4422 6Th Ave Se
Lacey WA 98503-1020
Phone: (360) 704-7170
Fax: (360) 412-4982
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LW00004165 | Washington |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LW00004165 | Washington |
Profile Details
| NPI number | 1700950557 |
|---|---|
| LBN Legal business name | Fredericksen, Gary J |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Jul 20th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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