Healthcare Provider Details

I. General information

NPI: 1043133846
Provider Name (Legal Business Name): MICHELLE M. EHLE PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 CATON WAY SW
OLYMPIA WA
98502-1119
US

IV. Provider business mailing address

2985 WINTHROP CIR SW
TUMWATER WA
98512-6265
US

V. Phone/Fax

Practice location:
  • Phone: 206-384-2712
  • Fax:
Mailing address:
  • Phone: 206-384-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: