Healthcare Provider Details

I. General information

NPI: 1528986346
Provider Name (Legal Business Name): MICHELLE LEWIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 12TH AVE S STE 401
SEATTLE WA
98144-2730
US

IV. Provider business mailing address

1000 MARION ST NE
OLYMPIA WA
98506-4431
US

V. Phone/Fax

Practice location:
  • Phone: 206-548-3806
  • Fax:
Mailing address:
  • Phone: 206-548-3806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00174003
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: