Healthcare Provider Details

I. General information

NPI: 1841790706
Provider Name (Legal Business Name): KARLA IVETTE PARRA MACHUCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2018
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14508 NE 20TH AVE
VANCOUVER WA
98686-6424
US

IV. Provider business mailing address

14508 NE 20TH AVE
VANCOUVER WA
98686-6424
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-9211
  • Fax: 360-260-4900
Mailing address:
  • Phone: 360-397-9211
  • Fax: 360-260-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF61274660
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: