MEDICARE: MRS. MICHELLE EDITH COWAN RN BSN

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
1	163WS0200X	School Registered Nurse	60077118	WA

General Provider Information

NPI Number	:	1487907945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE EDITH COWAN RN BSN

Provider Business Mailing Address
First Line	:	305 HARRISON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-4623
Country	:	US
Telephone Number	:	206-252-9857
Fax Number	:	206-252-9851

Provider Business Practice Location Address
First Line	:	305 HARRISON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-4623
Country	:	US
Telephone Number	:	206-252-9857
Fax Number	:	206-252-9851

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2012
Last Update Date	:	10/22/2012

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