Provider Demographics
NPI:1467696427
Name:VERCELLA, MICHELE M (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:VERCELLA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2324 EASTLAKE AVE E
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3345
Mailing Address - Country:US
Mailing Address - Phone:206-427-6311
Mailing Address - Fax:206-838-4599
Practice Address - Street 1:2324 EASTLAKE AVE E
Practice Address - Street 2:SUITE 400
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3345
Practice Address - Country:US
Practice Address - Phone:206-427-6311
Practice Address - Fax:206-838-4599
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000165641835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric