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1235434341
BRENT M DEBOLT
VANCOUVER, WA
NPI
1235434341
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: WA LP60203433)
Enumeration Date
2011-01-20
Last Update Date
2011-01-20
Business Address
-- BRENT M DEBOLT LPN
2314 E 13TH ST
VANCOUVER, WA 98661-4122
Phone number: 503-709-7122
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Mailing Address
-- BRENT M DEBOLT LPN
2314 E 13TH ST
VANCOUVER, WA 98661-4122
Phone number: 503-709-7122
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