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1487045068
ELLERY HOLESAPPLE
VANCOUVER, WA
NPI
1487045068
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CO60494014)
Enumeration Date
2015-02-18
Last Update Date
2015-02-18
Business Address
Mr. ELLERY HOLESAPPLE CDPT
1601 E 4TH PLAIN BLVD
VANCOUVER, WA 98661-3753
Phone number: 360-397-8246
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Mailing Address
Mr. ELLERY HOLESAPPLE CDPT
PO BOX 1678
VANCOUVER, WA 98668-1678
Phone number: 360-397-8246
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