Healthcare Provider Details

I. General information

NPI: 1013345099
Provider Name (Legal Business Name): MICHELLE HAMILTON LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 WALL ST STE 2D
EVERETT WA
98201-3942
US

IV. Provider business mailing address

1316 WALL ST STE 2D
EVERETT WA
98201-3942
US

V. Phone/Fax

Practice location:
  • Phone: 425-340-3500
  • Fax: 425-287-6398
Mailing address:
  • Phone: 425-340-3500
  • Fax: 425-642-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW60503566
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60403566
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: