Healthcare Provider Details

I. General information

NPI: 1316861677
Provider Name (Legal Business Name): KAREN MCNEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21810 NE 37TH AVE
RIDGEFIELD WA
98642-7747
US

IV. Provider business mailing address

18224 NE CEDAR DR
BATTLE GROUND WA
98604-7316
US

V. Phone/Fax

Practice location:
  • Phone: 360-335-7788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCPST.PE.70078938
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: