Individual
MICHELE M CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1530 S UNION AVE STE 1, TACOMA, WA 98405-1954
(253) 759-3333
(253) 759-1415
Mailing address
1530 S UNION AVE STE 1, TACOMA, WA 98405-1954
(253) 759-3333
(253) 759-1415
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00039058
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202849
—
WA
Enumeration date
11/19/2010
Last updated
11/11/2014
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