Individual
JEFFREY CARL MICHAELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 S LOUISIANA ST STE 5, KENNEWICK, WA 99336-9002
(509) 392-2341
Mailing address
1041 LETHBRIDGE AVE, RICHLAND, WA 99352-7810
(321) 200-4650
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MC61506052
WA
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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