Healthcare Provider Details

I. General information

NPI: 1346326147
Provider Name (Legal Business Name): MICHELE A DESPREAUX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 TALBOT RD S STE 570
RENTON WA
98055-5700
US

IV. Provider business mailing address

4033 TALBOT RD S STE 500
RENTON WA
98055-5704
US

V. Phone/Fax

Practice location:
  • Phone: 425-690-3489
  • Fax: 425-690-9089
Mailing address:
  • Phone: 425-690-3489
  • Fax: 425-690-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD00033813
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00033813
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: