Healthcare Provider Details

I. General information

NPI: 1013101369
Provider Name (Legal Business Name): JAIME PRATKA M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2614 FORT VANCOUVER WAY STE D
VANCOUVER WA
98661-3971
US

IV. Provider business mailing address

2614 FORT VANCOUVER WAY STE D
VANCOUVER WA
98661-3971
US

V. Phone/Fax

Practice location:
  • Phone: 360-696-4844
  • Fax: 360-696-4044
Mailing address:
  • Phone: 360-696-4844
  • Fax: 360-696-4044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: