Provider Demographics
NPI:1417105651
Name:PAULY, MICHAEL CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHARLES
Last Name:PAULY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2271 NE 51ST ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5713
Mailing Address - Country:US
Mailing Address - Phone:206-251-6211
Mailing Address - Fax:206-522-7815
Practice Address - Street 1:2271 NE 51ST ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5713
Practice Address - Country:US
Practice Address - Phone:206-251-6211
Practice Address - Fax:206-522-7815
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600196952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry