Individual
MICHELLE MONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27121 174TH PL SE STE 101, COVINGTON, WA 98042-4939
(253) 347-3343
(253) 638-7465
Mailing address
17801 SE 259TH PL, COVINGTON, WA 98042-8379
(253) 347-3343
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF00001859
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05043
—
WA
Enumeration date
01/30/2008
Last updated
07/21/2022
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