Provider Demographics
NPI:1437531373
Name:THOMPSON, MICHELLE DAWN (RDH)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DAWN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 8TH ST NE STE 102
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4589
Mailing Address - Country:US
Mailing Address - Phone:253-939-1863
Mailing Address - Fax:
Practice Address - Street 1:1320 8TH ST NE STE 102
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4589
Practice Address - Country:US
Practice Address - Phone:253-939-1863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIL60442828124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist