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NPI Code Detail

MEDICARE: MRS. MICHELLE KIM DISKIN MS

MEDICARE:  MRS. MICHELLE KIM DISKIN  MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH60420736WA

General Provider Information

NPI Number : 1104381243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE KIM DISKIN MS
Provider Business Mailing Address
First Line : 2044 N 77TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98103-4906
Country : US
Telephone Number : 415-828-4304
Fax Number :
Provider Business Practice Location Address
First Line : 5306 BALLARD AVE NW STE 403
Second Line :
City : SEATTLE
State : WA
Zip : 98107-4367
Country : US
Telephone Number : 415-828-4304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2019
Last Update Date : 02/03/2019

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Directions to “ MRS. MICHELLE KIM DISKIN MS” Practice Location

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