Individual
MICHELLE EMILY MODAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3023 80TH AVE SE STE 200, MERCER ISLAND, WA 98040-6014
(206) 690-5417
Mailing address
2519 13TH AVE S, SEATTLE, WA 98144-5008
(573) 308-0333
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
DE61149859
WA
Other
Enumeration date
04/03/2018
Last updated
07/15/2024
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