JESSE LA RAY WAYNE LYONS

PORT ORCHARD, WA
NPI1619755931
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO61212988)
Enumeration Date2023-09-18
Last Update Date2023-09-18
Business Address
JESSE LA RAY WAYNE LYONS SUDPT
661 TAYLOR ST
PORT ORCHARD, WA 98366-4300
Phone number: 360-337-5753
Mailing Address
JESSE LA RAY WAYNE LYONS SUDPT
614 DIVISION ST # MS -19
PORT ORCHARD, WA 98366-4614
Phone number: 360-337-5753
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