Provider Demographics
NPI:1609110436
Name:BILLS, MICHAEL PERRY JR (EDS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PERRY
Last Name:BILLS
Suffix:JR
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4962
Mailing Address - Country:US
Mailing Address - Phone:509-888-1240
Mailing Address - Fax:509-884-8805
Practice Address - Street 1:955 3RD ST NE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4962
Practice Address - Country:US
Practice Address - Phone:509-888-1240
Practice Address - Fax:509-884-8805
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA316993E103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool