Healthcare Provider Details

I. General information

NPI: 1962613992
Provider Name (Legal Business Name): MICHELLE LEANNE SWENSON MA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1644 PLAZA WAY # 325
WALLA WALLA WA
99362-4325
US

IV. Provider business mailing address

1644 PLAZA WAY # 325
WALLA WALLA WA
99362-4325
US

V. Phone/Fax

Practice location:
  • Phone: 509-713-0555
  • Fax: 509-231-8555
Mailing address:
  • Phone: 509-713-0555
  • Fax: 509-231-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number60247271
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: