Provider Demographics
NPI:1114598141
Name:UBELL, MICHELLE (L AC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:UBELL
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:TROUT LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98650-0053
Mailing Address - Country:US
Mailing Address - Phone:509-281-1358
Mailing Address - Fax:
Practice Address - Street 1:288 E JEWETT BLVD
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-3000
Practice Address - Country:US
Practice Address - Phone:509-281-1358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61153026171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist