Brent M Debolt, LPN | |
2314 E 13th St, Vancouver, WA 98661-4122 | |
(503) 709-7122 | |
Not Available |
Full Name | Brent M Debolt |
---|---|
Gender | Male |
Speciality | Licensed Practical Nurse |
Location | 2314 E 13th St, Vancouver, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235434341 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
164W00000X | Licensed Practical Nurse | LP60203433 (Washington) | Primary |
Mailing Address | Practice Location Address |
---|---|
Brent M Debolt, LPN 2314 E 13th St, Vancouver, WA 98661-4122 Ph: (503) 709-7122 | Brent M Debolt, LPN 2314 E 13th St, Vancouver, WA 98661-4122 Ph: (503) 709-7122 |
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