Individual
DR. JERRY ALEXANDER MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9040 JACKSON AVENUE, TACOMA, WA 98431-4746
(253) 968-2130
(253) 968-3140
Mailing address
2114 LAFAYETTE ST, STEILACOOM, WA 98388-1346
(360) 481-4705
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00036387
WA
2085R0202X
Diagnostic Radiology Physician
MD00036387
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00036387
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1092032
—
WA
Enumeration date
11/09/2005
Last updated
03/13/2023
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