Healthcare Provider Details

I. General information

NPI: 1750206488
Provider Name (Legal Business Name): MIHCA ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 44TH AVE SW # 201A
SEATTLE WA
98116-4052
US

IV. Provider business mailing address

10715 26TH AVE SW
SEATTLE WA
98146-1905
US

V. Phone/Fax

Practice location:
  • Phone: 253-271-9070
  • Fax:
Mailing address:
  • Phone: 253-271-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA70159685
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: