Provider Demographics
NPI:1235780586
Name:GRAHAM, KARLA JO
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:JO
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 NE 131ST CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6428
Mailing Address - Country:US
Mailing Address - Phone:360-723-2388
Mailing Address - Fax:
Practice Address - Street 1:2621 NE 131ST CT
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6428
Practice Address - Country:US
Practice Address - Phone:360-723-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula