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NPI Code Detail

MEDICARE: MICHAEL VERDONK

MEDICARE: MICHAEL VERDONK
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 CounselorMC61480939WA

General Provider Information

NPI Number : 1881313112
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL VERDONK
Provider Business Mailing Address
First Line : PO BOX 2429
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-8486
Country : US
Telephone Number : 360-353-9494
Fax Number : 360-353-9440
Provider Business Practice Location Address
First Line : 15455 65TH AVE S
Second Line :
City : TUKWILA
State : WA
Zip : 98188-2534
Country : US
Telephone Number : 206-721-5170
Fax Number : 360-353-9440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2022
Last Update Date : 05/05/2026

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