Individual
LACEY VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 506-5731
Mailing address
2109 N COLUMBUS AVE, GOLDENDALE, WA 98620-3327
(509) 250-0226
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000110057
OR
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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