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General NPI Number Information
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NPI Number | 1225090566
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Entity Type | Individual
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Provider Name | MICHELLE J. GOTTSCHLICH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 21600 HIGHWAY 99 SUITE 260
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City | EDMONDS
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State | WA
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Zip | 98026-8012
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Country | US
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Telephone | 425-774-2650
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Fax | 425-774-2643
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Provider Business Mailing Address
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Address Line | 16504 9TH SEAVE 106
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City | MILL CREEK
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State | WA
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Zip | 98012-6388
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Country | US
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Telephone | 425-977-4620
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Fax | 425-745-9836
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD60544549
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License Number State | WA
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