Healthcare Provider Details

I. General information

NPI: 1801360078
Provider Name (Legal Business Name): MICHELLE LEIGH ZINGHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2019
Last Update Date: 01/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12507 69TH AVE S # 23
SEATTLE WA
98178-4126
US

IV. Provider business mailing address

12507 69TH AVE S # 23
SEATTLE WA
98178-4126
US

V. Phone/Fax

Practice location:
  • Phone: 360-939-1050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60715277
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: