Individual
DR. MARK C MICHAEL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD, CGP
Contact information
Practice address
309 FEDERAL AVE E, STE A, SEATTLE, WA 98102-5416
(206) 324-8285
Mailing address
309 FEDERAL AVE E, STE A, SEATTLE, WA 98102-5416
(206) 324-8285
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00001182
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI-9953
REGENCE BLUE SHIELD
WA
Enumeration date
07/08/2005
Last updated
07/08/2007
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