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General NPI Number Information
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NPI Number | 1790080778
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Entity Type | Individual
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Provider Name | MICHELLE LAFONTAINE
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Gender | Female
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 2326 RAINIER AVE S
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City | SEATTLE
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State | WA
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Zip | 98144-5349
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Country | US
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Telephone | 206-329-3040
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Fax | 206-329-3041
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Provider Business Mailing Address
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Address Line | 2326 RAINIER AVE S STE B
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City | SEATTLE
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State | WA
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Zip | 98144-5349
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Country | US
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Telephone | 206-329-3040
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Fax | 206-329-3041
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60199615
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MA60199615
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License Number State | WA
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