Individual
MS. MICHELLE LOUISE WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
90 SE KLAH CHE MIN DR, SHELTON, WA 98584-9216
(360) 427-9006
(360) 427-1951
Mailing address
90 SE KLAH CHE MIN DR, SHELTON, WA 98584-9216
(360) 427-9006
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00004967
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5021761
—
WA
Enumeration date
03/27/2007
Last updated
07/08/2007
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