Provider Demographics
NPI:1225385537
Name:LE, MICHELLE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3633 SAPPHIRE DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4233
Mailing Address - Country:US
Mailing Address - Phone:206-861-6064
Mailing Address - Fax:
Practice Address - Street 1:3633 SAPPHIRE DR
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4233
Practice Address - Country:US
Practice Address - Phone:206-861-6064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00070592183500000X
CA72771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist