Individual
MARY WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
700 NE 112TH ST, VANCOUVER, WA 98685-3930
(360) 313-2750
Mailing address
700 NE 112TH ST, VANCOUVER, WA 98685-3930
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
60538200
WA
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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