Healthcare Provider Details

I. General information

NPI: 1205303286
Provider Name (Legal Business Name): MICHELE CYNTHIA LYNN VELASQUEZ DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 SUNSET LN NE # 106
RENTON WA
98056-3144
US

IV. Provider business mailing address

2715 SUNSET LN NE # 106
RENTON WA
98056-3144
US

V. Phone/Fax

Practice location:
  • Phone: 425-873-6184
  • Fax: 425-988-9349
Mailing address:
  • Phone: 425-873-6184
  • Fax: 425-988-9349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number60893557
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: