Healthcare Provider Details

I. General information

NPI: 1104516772
Provider Name (Legal Business Name): MICHAEL HINRICHS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 N 205TH ST
SHORELINE WA
98133-3214
US

IV. Provider business mailing address

10419 NE 200TH ST
BOTHELL WA
98011-2473
US

V. Phone/Fax

Practice location:
  • Phone: 206-546-2220
  • Fax:
Mailing address:
  • Phone: 206-979-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: