Provider Demographics
NPI:1205379765
Name:MICHIELI-WELCH, DARBY
Entity Type:Individual
Prefix:
First Name:DARBY
Middle Name:
Last Name:MICHIELI-WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-1334
Mailing Address - Country:US
Mailing Address - Phone:253-302-6666
Mailing Address - Fax:
Practice Address - Street 1:2709 OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-1334
Practice Address - Country:US
Practice Address - Phone:253-302-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist