Healthcare Provider Details

I. General information

NPI: 1528570793
Provider Name (Legal Business Name): MICHELE D MAYATTE ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2017
Last Update Date: 05/12/2023
Certification Date: 04/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 MAIN ST
SULTAN WA
98294-0197
US

IV. Provider business mailing address

7231 NE 152ND PL
KENMORE WA
98028-4653
US

V. Phone/Fax

Practice location:
  • Phone: 360-793-3883
  • Fax:
Mailing address:
  • Phone: 260-660-0442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: