Individual
MCKAYLA PAULINE PALASTHIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1498 SE TECH CENTER PL, VANCOUVER, WA 98683-9591
(360) 448-7464
Mailing address
7704 NE 159TH AVE, VANCOUVER, WA 98682-3807
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP61043893
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP61043893
CREDENTIAL
WA
Enumeration date
02/04/2022
Last updated
02/04/2022
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