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Individual
ROBERTA L MCMICHAEL
Active
Individual
ROBERTA L MCMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00006002
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039585
LABOR AND INDUSTRIES #
WA
05
—
8395592
—
WA
01
—
MC2662
BLUE SHIELD #
WA
01
—
P00238672
RAILROAD MC#
WA
01
—
US1051963
AETNA SPECIALIST PIN
WA
Enumeration date
01/18/2007
Last updated
10/15/2021
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