JOHN LACY

PORTLAND, OR
NPI1003431362
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence:   professionallicense)
Enumeration Date2020-06-12
Last Update Date2024-06-05
Business Address
JOHN LACY
17640 NE HALSEY ST
PORTLAND, OR 97230-6733
Phone number: 503-489-5045
Mailing Address
JOHN LACY
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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