Individual
MIRA CHETLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 NE 139TH ST STE 200, VANCOUVER, WA 98686-2316
(360) 487-1778
Mailing address
2121 NE 139TH ST STE 200, VANCOUVER, WA 98686-2316
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/04/2018
Last updated
12/09/2025
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