person
Jesse La Ray Wayne Lyons, SUDPT
Addiction (Substance Use Disorder) Counselor in Port Orchard, Washington
NPI 1619755931

Jesse La Ray Wayne Lyons is an Addiction (Substance Use Disorder) Counselor based in Port Orchard, WA and is specialized in Addiction (Substance Use Disorder). Jesse La Ray Wayne Lyons practices in Port Orchard, WA and has the professional credentials of SUDPT. The NPI Number for Jesse La Ray Wayne Lyons is 1619755931 and holds a License No. CO61212988 (Washington).

The current practice location address for Jesse La Ray Wayne Lyons is 661 Taylor St, Port Orchard, WA and can be reached out via phone at 360-337-5753 and via fax at 888-834-8027. You can also correspond with Jesse La Ray Wayne Lyons through the mailing address at 614 DIVISION ST # MS -19, PORT ORCHARD, WA - 98366-4614 (mailing address contact number: 360-337-5753).

Location: 661 Taylor St, Port Orchard, WA, 98366-4614
person
Provider Profile Details
NPI Number
1619755931
Provider Name
Jesse La Ray Wayne Lyons
Credential
SUDPT
Provider Entity Type
Individual
Gender
Male
Address
661 Taylor St, Port Orchard, WA, 98366-4614
Phone Number
360-337-5753
Fax Number
888-834-8027
Provider Enumeration Date
09/18/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
661 Taylor St
City
State
Zip
98366-4300
Phone Number
360-337-5753
Fax Number
888-834-8027
person
Provider Business Mailing Address Details
Address
661 Taylor St
City
State
Zip
98366-4300
Phone Number
360-337-5753
Fax Number
888-834-8027
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CO61212988 (Washington)
Definition
Definition to come...
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