Healthcare Provider Details

I. General information

NPI: 1518418664
Provider Name (Legal Business Name): MICHELLE ANN ALLEN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13307 NE HIGHWAY 99 STE 113
VANCOUVER WA
98686-3033
US

IV. Provider business mailing address

6014 NE 50TH AVE
VANCOUVER WA
98661-1863
US

V. Phone/Fax

Practice location:
  • Phone: 360-314-2761
  • Fax: 360-309-7951
Mailing address:
  • Phone: 971-777-2499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60793469
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: