Provider Demographics
NPI:1326407123
Name:DESMOND, MICHELLE DANIELLE (MSW, MPH)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:DANIELLE
Last Name:DESMOND
Suffix:
Gender:F
Credentials:MSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 S HOLLY ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3329
Mailing Address - Country:US
Mailing Address - Phone:206-856-5502
Mailing Address - Fax:
Practice Address - Street 1:4603 S HOLLY ST UNIT B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3329
Practice Address - Country:US
Practice Address - Phone:206-856-5502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical