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General NPI Number Information
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NPI Number | 1306986708
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Entity Type | Individual
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Provider Name | MICHELLE A MCDONALD LMP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1601 2ND AVE N STE 217
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City | GREAT FALLS
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State | MT
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Zip | 59401-3243
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Country | US
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Telephone | 253-630-6768
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 2ND AVE N STE 217
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City | GREAT FALLS
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State | MT
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Zip | 59401-3243
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Country | US
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Telephone | 253-350-1928
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00003344
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 11914
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License Number State | MT
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