Individual
KELLI MICHELLE DOUGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2500 NE 65TH AVE, VANCOUVER, WA 98661-6812
(360) 952-3644
Mailing address
712 NE 138TH PL, VANCOUVER, WA 98684-4604
(360) 921-4263
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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