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1275015182
LUIS GEOVANNY HERNANDEZ
VANCOUVER, WA
NPI
1275015182
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-09-06
Last Update Date
2018-09-06
Business Address
LUIS GEOVANNY HERNANDEZ
1601 E FOURTH PLAIN BLVD BLDG 17
VANCOUVER, WA 98661-3717
Phone number: 360-397-8484
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Mailing Address
LUIS GEOVANNY HERNANDEZ
PO BOX 1845
VANCOUVER, WA 98668-1845
Phone number:
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