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NPI Code Detail

MEDICARE: MICHELLE RIE OKADA PA-C

MEDICARE: MICHELLE RIE OKADA PA-C
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
1363A00000XPhysician AssistantPA58603CA
2363A00000XPhysician Assistant5601007540MI
3363AM0700XMedical Physician Assistant5601007540MI

General Provider Information

NPI Number : 1497129860
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE RIE OKADA PA-C
Provider Business Mailing Address
First Line : 26901 BEAUMONT BLVD STE 3D
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48033-3849
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 44201 DEQUINDRE RD
Second Line :
City : TROY
State : MI
Zip : 48085-1117
Country : US
Telephone Number : 248-964-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2015
Last Update Date : 02/13/2026

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Directions to “ MICHELLE RIE OKADA PA-C” Practice Location

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