Provider Demographics
NPI:1093143380
Name:MINSHALL, MICHELLE (ND)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:MINSHALL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4208 LEARY WAY NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4535
Mailing Address - Country:US
Mailing Address - Phone:206-552-8729
Mailing Address - Fax:
Practice Address - Street 1:4208 LEARY WAY NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4535
Practice Address - Country:US
Practice Address - Phone:206-552-8729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60407802175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath