Healthcare Provider Details

I. General information

NPI: 1871177535
Provider Name (Legal Business Name): MICHELLE AMBER BOROWITZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE AMBER JOYNER PHD

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

300 W HALLADAY ST
SEATTLE WA
98119-2371
US

V. Phone/Fax

Practice location:
  • Phone: 206-764-2163
  • Fax:
Mailing address:
  • Phone: 925-783-9223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY61075106
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: