Individual
MICAH GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2502 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3965
(360) 831-0904
Mailing address
2502 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3965
(360) 831-0904
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWAA.SA.61479326
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2264469
—
WA
Enumeration date
09/08/2023
Last updated
09/02/2025
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