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Individual

MICAH SANDERS-MASSINGALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2811 NE 139TH ST, VANCOUVER, WA 98686-2724
(360) 574-5247
Mailing address
2811 NE 139TH ST, VANCOUVER, WA 98686-2724
(360) 574-5247

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
14073
OR
235Z00000X
Speech-Language Pathologist
Primary
LL 60401896
WA

Other

Enumeration date
09/27/2012
Last updated
08/24/2024
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