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NPI Code Detail

MEDICARE: DR. JARED D. MICHONSKI PH.D.

MEDICARE: DR. JARED D. MICHONSKI PH.D.
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
1103TB0200XCognitive & Behavioral Psychologist
2103T00000XPsychologist

General Provider Information

NPI Number : 1952699308
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JARED D. MICHONSKI PH.D.
Provider Business Mailing Address
First Line : 600 N 36TH ST STE 305
Second Line :
City : SEATTLE
State : WA
Zip : 98103-8698
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 N 36TH ST STE 305
Second Line :
City : SEATTLE
State : WA
Zip : 98103-8698
Country : US
Telephone Number : 206-659-8768
Fax Number : 206-792-3630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2011
Last Update Date : 01/19/2026

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