Individual
MIKALYN RAYANN WOODRUFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 KERN WAY, YAKIMA, WA 98902-6340
(509) 574-3200
Mailing address
918 EAST MEAD AVENUE, YAKIMA, WA 98903-3720
(509) 453-1344
(509) 453-2209
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60733093
WA
106E00000X
Assistant Behavior Analyst
Primary
CG 60733093
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316486764
—
WA
Enumeration date
02/17/2017
Last updated
06/05/2017
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