Individual
MRS. MICAH LAURAINE INGALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
8815 S TACOMA WAY, SUITE 122, LAKEWOOD, WA 98499-4587
(253) 682-0320
(253) 582-2901
Mailing address
8928 NE COUCH ST, PORTLAND, OR 97220-5945
(971) 276-9639
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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