Healthcare Provider Details

I. General information

NPI: 1871471383
Provider Name (Legal Business Name): KARLA PAOLA CUPA-BARRON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NE 139TH ST STE 200
VANCOUVER WA
98686-2316
US

IV. Provider business mailing address

2121 NE 139TH ST STE 200
VANCOUVER WA
98686-2316
US

V. Phone/Fax

Practice location:
  • Phone: 360-487-1778
  • Fax:
Mailing address:
  • Phone: 360-487-1778
  • Fax: 360-487-1779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.LL.70016058
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: