Provider Demographics
NPI:1093753220
Name:MORRISON, MICHELE D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:D
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:123 S MARKET BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3037
Mailing Address - Country:US
Mailing Address - Phone:360-748-9700
Mailing Address - Fax:360-748-9725
Practice Address - Street 1:123 S MARKET BLVD
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3037
Practice Address - Country:US
Practice Address - Phone:360-748-9700
Practice Address - Fax:360-748-9725
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00043716207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE93140Medicare UPIN