Provider Demographics
NPI:1679927735
Name:KEIDAR, MICHAL
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:KEIDAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHAL
Other - Middle Name:
Other - Last Name:GOLDRING KEIDAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4507 PALATINE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6336
Mailing Address - Country:US
Mailing Address - Phone:206-618-1594
Mailing Address - Fax:
Practice Address - Street 1:1307 N 45TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6741
Practice Address - Country:US
Practice Address - Phone:206-420-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker