Healthcare Provider Details

I. General information

NPI: 1811383375
Provider Name (Legal Business Name): MICHELE WILLIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2015
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2643 PATTERSON RD STE 603
GRAND JUNCTION CO
81506-1937
US

IV. Provider business mailing address

2643 PATTERSON RD STE 603
GRAND JUNCTION CO
81506-1937
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-3801
  • Fax: 970-232-2860
Mailing address:
  • Phone: 970-298-3801
  • Fax: 970-232-2860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberDR.0062121
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number85547
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: