Individual
KAILEY A WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
11719 NE 95TH ST STE A, VANCOUVER, WA 98682-2444
(503) 490-2292
Mailing address
11719 NE 95TH ST STE A, VANCOUVER, WA 98682-2444
(503) 490-2292
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
PHW2019
OR
175T00000X
Peer Specialist
Primary
CG61009839
WA
175T00000X
Peer Specialist
THW2019
OR
Other
Enumeration date
10/06/2017
Last updated
11/18/2019
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