Healthcare Provider Details

I. General information

NPI: 1740194216
Provider Name (Legal Business Name): LAY PHENG TAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANICE TAY

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 NE 87TH AVE
VANCOUVER WA
98664-1915
US

IV. Provider business mailing address

655 S PEKIN RD
WOODLAND WA
98674-9592
US

V. Phone/Fax

Practice location:
  • Phone: 360-558-5770
  • Fax: 360-558-5782
Mailing address:
  • Phone: 360-608-7939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70113225
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: