Provider Demographics
NPI:1659597433
Name:MCNEAL, MICHELLE ANN (PT, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANN
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S FOREST ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5811
Mailing Address - Country:US
Mailing Address - Phone:360-671-2060
Mailing Address - Fax:360-671-2060
Practice Address - Street 1:233 S FOREST ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5811
Practice Address - Country:US
Practice Address - Phone:360-671-2060
Practice Address - Fax:360-671-2060
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000099222251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics