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1912485012
JOHN BRUCE LILES
VANCOUVER, WA
NPI
1912485012
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-07-31
Last Update Date
2018-07-31
Business Address
JOHN BRUCE LILES
1601 E FOURTH PLAIN BLVD BLDG 17
VANCOUVER, WA 98661-3717
Phone number: 360-397-8484
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Mailing Address
JOHN BRUCE LILES
PO BOX 1845
VANCOUVER, WA 98668-1845
Phone number: 360-397-8484
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