MEDICARE: MS. MICHELE BAYLE L.D.O.

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	156FX1800X	Optician	DO00001681	WA

General Provider Information

NPI Number	:	1982971172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE BAYLE L.D.O.

Provider Business Mailing Address
First Line	:	4854 RAINIER AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1742
Country	:	US
Telephone Number	:	206-722-3939
Fax Number	:	206-826-9140

Provider Business Practice Location Address
First Line	:	4854 RAINIER AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1742
Country	:	US
Telephone Number	:	206-722-3939
Fax Number	:	206-826-9140

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

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	11/16/2011

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