JESSE LA RAY WAYNE LYONS

PORT ORCHARD, WA
NPI1619755931
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CP61648364)
Enumeration Date2023-09-18
Last Update Date2026-05-26
Business Address
Mr. JESSE LA RAY WAYNE LYONS SUDP
1026 SIDNEY AVE
PORT ORCHARD, WA 98366-4214
Phone number: 360-337-5753
Mailing Address
Mr. JESSE LA RAY WAYNE LYONS SUDP
614 DIVISION ST # MS -19
PORT ORCHARD, WA 98366-4614
Phone number: 360-337-5753