TYLER SHANE DOUGLAS

YAKIMA, WA
NPI1427536481
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO60769562)
Enumeration Date2018-08-01
Last Update Date2018-08-01
Business Address
Mr. TYLER SHANE DOUGLAS CO60769562
2280 STATE ROUTE 821
YAKIMA, WA 98901-8302
Phone number: 509-457-0990
Mailing Address
Mr. TYLER SHANE DOUGLAS CO60769562
PO BOX 217
SELAH, WA 98942-0217
Phone number: 509-457-0990
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