Individual
BROOKE STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16821 SE MCGILLIVRAY BLVD STE 100, VANCOUVER, WA 98683-0401
(360) 818-9593
Mailing address
16821 SE MCGILLIVRAY BLVD STE 100, VANCOUVER, WA 98683-0401
(360) 818-9593
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61638066
WA
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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