=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609110436
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL PERRY BILLS JR. ED.S
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2012
-----------------------------------------------------
Last Update Date | 11/16/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 955 3RD ST NE
-----------------------------------------------------
City | EAST WENATCHEE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98802-4962
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-888-1240
-----------------------------------------------------
Fax | 509-884-8805
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 955 3RD ST NE
-----------------------------------------------------
City | EAST WENATCHEE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98802-4962
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-888-1240
-----------------------------------------------------
Fax | 509-884-8805
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | 316993E
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------