Healthcare Provider Details

I. General information

NPI: 1447045125
Provider Name (Legal Business Name): MICHELLE KAY ANN BACANI RESPIRATORY THERAPIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2025
Last Update Date: 04/12/2025
Certification Date: 04/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST MAIN HOSPITRAL
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

13117 SE 214TH WAY
KENT WA
98031-3915
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-3300
  • Fax:
Mailing address:
  • Phone: 206-250-5163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number60965739
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: