ERIC WADE LYSNE

PORTLAND, OR
NPI1700607686
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  T-24-3638)
Enumeration Date2024-10-23
Last Update Date2024-10-23
Business Address
ERIC WADE LYSNE CADC-R, CRM1
10564 SE WASHINGTON ST
PORTLAND, OR 97216-2809
Phone number: 503-228-9229
Mailing Address
ERIC WADE LYSNE CADC-R, CRM1
10564 SE WASHINGTON ST
PORTLAND, OR 97216-2809
Phone number: 503-228-9229
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