Provider Demographics
NPI:1598842544
Name:THOMPSON, MICHELE MCKEE (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:MCKEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 SE 136TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6923
Mailing Address - Country:US
Mailing Address - Phone:360-450-6800
Mailing Address - Fax:360-989-1150
Practice Address - Street 1:234 SE 136TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6923
Practice Address - Country:US
Practice Address - Phone:360-450-6800
Practice Address - Fax:360-989-1150
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046795207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology