Provider Demographics
NPI:1437480456
Name:VANESSA MICHEL PLLC
Entity Type:Organization
Organization Name:VANESSA MICHEL PLLC
Other - Org Name:REDMOND RIDGE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-898-9222
Mailing Address - Street 1:23535 NE NOVELTY HILL RD
Mailing Address - Street 2:D302
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-5502
Mailing Address - Country:US
Mailing Address - Phone:425-898-9222
Mailing Address - Fax:425-898-9225
Practice Address - Street 1:23535 NE NOVELTY HILL RD
Practice Address - Street 2:D302
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5502
Practice Address - Country:US
Practice Address - Phone:425-898-9222
Practice Address - Fax:425-898-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3908152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV00545Medicare UPIN
WA8863123Medicare PIN