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1194375105
GIDEON LEE FAULCONER
VANCOUVER, WA
NPI
1194375105
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-09-12
Last Update Date
2019-09-12
Business Address
GIDEON LEE FAULCONER
1601 E FOURTH PLAIN BLVD BLDG 17
VANCOUVER, WA 98661-3717
Phone number: 360-397-8484
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Mailing Address
GIDEON LEE FAULCONER
PO BOX 1845
VANCOUVER, WA 98668-1845
Phone number:
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