Provider Demographics
NPI:1720566219
Name:ALLERT, MICHELL
Entity Type:Individual
Prefix:
First Name:MICHELL
Middle Name:
Last Name:ALLERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9013 26TH AVE S
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8317
Mailing Address - Country:US
Mailing Address - Phone:253-209-4260
Mailing Address - Fax:
Practice Address - Street 1:15 S GRADY WAY STE 310
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3215
Practice Address - Country:US
Practice Address - Phone:206-726-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health