MEDICARE: DR. MICHAEL R. KULFAN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH00011215	WA
2	103G00000X	Clinical Neuropsychologist	PY60424304	WA

General Provider Information

NPI Number	:	1578732426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL R. KULFAN PSYD

Provider Business Mailing Address
First Line	:	1405 NW 85TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-4237
Country	:	US
Telephone Number	:	206-947-4606
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 NW 85TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-4237
Country	:	US
Telephone Number	:	206-947-4606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	09/09/2014

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