Healthcare Provider Details

I. General information

NPI: 1801810908
Provider Name (Legal Business Name): MICHELLE SEELIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 6TH AVE STE 102
SEATTLE WA
98121-1817
US

IV. Provider business mailing address

2200 6TH AVE STE 102
SEATTLE WA
98121-1817
US

V. Phone/Fax

Practice location:
  • Phone: 206-456-2500
  • Fax: 206-589-6900
Mailing address:
  • Phone: 206-456-2500
  • Fax: 206-589-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA79449
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD00046907
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: