Individual
MIKALA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6409 E MILL PLAIN BLVD, VANCOUVER, WA 98661-7454
(360) 984-3195
Mailing address
1040 NW NAITO PKWY APT O2, PORTLAND, OR 97209-3753
(503) 780-8882
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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