MEDICARE: MICHELLE ANN HOARD 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
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1568743110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ANN HOARD MS

Provider Business Mailing Address
First Line	:	2427 62ND AVE E
Second Line	:	#27-201
City	:	FIFE
State	:	WA
Zip	:	98424-3553
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 112TH AVE NE
Second Line	:	SUITE 100
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4509
Country	:	US
Telephone Number	:	425-688-8111
Fax Number	:

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

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	09/08/2011

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