Individual
ARDYS DEANE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 S 2ND ST, MOUNT VERNON, WA 98273-4209
(360) 419-3500
(360) 419-3505
Mailing address
PO BOX 515, CONCRETE, WA 98237-0515
(360) 853-7860
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RC00027484
WA
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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