Brent M Debolt LPN

NPI 1235434341 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1235434341
Gender Male
Enumeration Date 01/20/2011
Last Updated 01/20/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
2314 E 13TH ST
VANCOUVER WA, 98661-4122, US
Phone (503) 709-7122
Fax
Business Location
2314 E 13TH ST
VANCOUVER WA, 98661-4122, US
Phone (503) 709-7122
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Washington
License Number LP60203433
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According to our database, Brent M Debolt LPN NPI is 1235434341, taxonomy code is 164W00000X and license number is LP60203433, license state is located at Washington. Brent M Debolt LPN physically located at 2314 E 13th St, Vancouver WA, 98661-4122. NPI Number Brent M Debolt LPN has the Individual type.

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1235434341 NPI number is provided on an as is basis without warranty of any kind. 1235434341 is maintained by the National Plan & Provider Enumeration System. The contents of Brent M Debolt LPN are for informational purposes only.