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General NPI Number Information
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NPI Number | 1093964561
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Entity Type | Individual
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Provider Name | MICHELLE MARIE CANI BATTIN BA, MA, PHD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 8290 165TH AVE NE
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City | REDMOND
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State | WA
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Zip | 98052-3948
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Country | US
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Telephone | 425-869-2644
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Fax | 425-867-0930
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Provider Business Mailing Address
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Address Line | 400 NW GILMAN BLVD UNIT 571
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City | ISSAQUAH
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State | WA
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Zip | 98027-0292
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Country | US
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Telephone | 626-344-0634
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY26203
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60655194
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License Number State | WA
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