Healthcare Provider Details

I. General information

NPI: 1215624531
Provider Name (Legal Business Name): MICHELLE LYNN COAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 2ND AVE STE 208
SEATTLE WA
98101-1186
US

IV. Provider business mailing address

1902 2ND AVE STE 208
SEATTLE WA
98101-1186
US

V. Phone/Fax

Practice location:
  • Phone: 206-956-9570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.70032486
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: