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General NPI Number Information
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NPI Number | 1245773787
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Entity Type | Individual
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Provider Name | MICHELLE MORSE
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Gender | Female
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Dates
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Enumeration Date | 12/01/2016
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 26129 CALVARY LN NE STE. #200
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City | KINGSTON
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State | WA
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Zip | 98346-7404
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Country | US
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Telephone | 360-881-0395
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Fax | 360-297-7772
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Provider Business Mailing Address
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Address Line | 954 NW SELBO RD
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City | BREMERTON
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State | WA
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Zip | 98311-9089
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Country | US
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Telephone | 360-621-2823
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 604-041-038
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License Number State | WA
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