JOHNATHAN SAMUEL DETWILER

VANCOUVER, WA
NPI1558829457
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: WA  LH61055500)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: IN  39003508A)
101YM0800X Counselor, Mental Health
(Licence: OR  C5666)
Enumeration Date2019-03-10
Last Update Date2020-10-19
Business Address
JOHNATHAN SAMUEL DETWILER LMHC
5501 NE 109TH CT STE A1
VANCOUVER, WA 98662-6173
Phone number: 360-566-4432
Mailing Address
JOHNATHAN SAMUEL DETWILER LMHC
3124 NE 162ND AVE
PORTLAND, OR 97230-5524
Phone number: 260-348-9872