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1861561367
JOHN M LAKE
COLVILLE, WA
NPI
1861561367
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: WA LH0005634)
Enumeration Date
2006-11-07
Last Update Date
2007-07-08
Business Address
JOHN M LAKE MSW, LISW
165 E HAWTHORNE AVE
COLVILLE, WA 99114-2629
Phone number: 509-684-6172
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Mailing Address
JOHN M LAKE MSW, LISW
746 N OAK ST
COLVILLE, WA 99114-3148
Phone number: 509-684-6172
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