Provider Demographics
NPI:1326398686
Name:ROLFS, MICHELLE LYNN (LAC, EAMP, LMT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNN
Last Name:ROLFS
Suffix:
Gender:F
Credentials:LAC, EAMP, LMT
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:WERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16608 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-5918
Mailing Address - Country:US
Mailing Address - Phone:206-295-5337
Mailing Address - Fax:
Practice Address - Street 1:4027 21ST AVE W STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-1272
Practice Address - Country:US
Practice Address - Phone:206-295-5337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMAS60270868171W00000X
WAMA60270868225700000X
WAAC60855996171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No171W00000XOther Service ProvidersContractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAC60855996OtherACUPUNCTURE AND EASTERN MEDICINE PRACTITIONER