Provider Demographics
NPI:1760130819
Name:MCCABE, MICHELLE LYNN (RCEP, CCRP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:MCCABE
Suffix:
Gender:F
Credentials:RCEP, CCRP
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1450 5TH ST SE STE 2500
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4692
Mailing Address - Country:US
Mailing Address - Phone:253-697-3759
Mailing Address - Fax:253-697-3325
Practice Address - Street 1:1450 5TH ST SE STE 2500
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4692
Practice Address - Country:US
Practice Address - Phone:253-697-3759
Practice Address - Fax:253-697-3325
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist