MEDICARE: KARLA IVETTE PARRA MACHUCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LF61274660	WA

General Provider Information

NPI Number	:	1841790706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA IVETTE PARRA MACHUCA

Provider Business Mailing Address
First Line	:	14508 NE 20TH AVE
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98686-6424
Country	:	US
Telephone Number	:	360-397-9211
Fax Number	:	360-260-4900

Provider Business Practice Location Address
First Line	:	14508 NE 20TH AVE
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98686-6424
Country	:	US
Telephone Number	:	360-397-9211
Fax Number	:	360-260-4900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2018
Last Update Date	:	06/08/2026

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