Provider Demographics
NPI:1528570793
Name:MAYATTE, MICHELE D (ND)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:D
Last Name:MAYATTE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 NE 152ND PL
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-4653
Mailing Address - Country:US
Mailing Address - Phone:260-660-0442
Mailing Address - Fax:
Practice Address - Street 1:307 MAIN ST
Practice Address - Street 2:
Practice Address - City:SULTAN
Practice Address - State:WA
Practice Address - Zip Code:98294-0197
Practice Address - Country:US
Practice Address - Phone:360-793-3883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath