Individual
JONATHAN M WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 NE RIDDELL RD STE 110, BREMERTON, WA 98310-3005
(360) 288-7264
Mailing address
9711 DANWOOD LN NW APT 34, SILVERDALE, WA 98383-9148
(360) 535-3287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61157956
WA
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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