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Johnathan Samuel Detwiler, LMHC
Mental Health Counselor in Vancouver, Washington
NPI 1558829457

Johnathan Samuel Detwiler is a Mental Health Counselor based in Portland, WA and is specialized in Mental Health. Johnathan Samuel Detwiler practices in Vancouver, WA and has the professional credentials of LMHC. The NPI Number for Johnathan Samuel Detwiler is 1558829457 and holds a License No. 39003508A (Washington).

The current practice location address for Johnathan Samuel Detwiler is 5501 Ne 109Th Ct Ste A1, Vancouver, WA and can be reached out via phone at 360-566-4432.

Location: 5501 Ne 109Th Ct Ste A1, Vancouver, WA, 97230-5524
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558829457
Provider Name
Johnathan Samuel Detwiler
Credential
LMHC
Provider Entity Type
Individual
Gender
Male
Address
5501 Ne 109Th Ct Ste A1, Vancouver, WA, 97230-5524
Phone Number
360-566-4432
Fax Number
Provider Enumeration Date
03/10/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5501 Ne 109Th Ct Ste A1
City
Vancouver
State
Washington
Zip
98662-6173
Phone Number
360-566-4432
Fax Number
person
Provider Business Mailing Address Details
Address
5501 Ne 109Th Ct Ste A1
City
Vancouver
State
Washington
Zip
98662-6173
Phone Number
360-566-4432
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
39003508A (Indiana)
Definition
Definition to come...
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