Provider Demographics
NPI:1851642755
Name:SCHUSTER, MICHELE JEAN (MED)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:JEAN
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 E POLE RD
Mailing Address - Street 2:
Mailing Address - City:EVERSON
Mailing Address - State:WA
Mailing Address - Zip Code:98247-9745
Mailing Address - Country:US
Mailing Address - Phone:360-988-2641
Mailing Address - Fax:
Practice Address - Street 1:3326 E BADGER RD
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247-9232
Practice Address - Country:US
Practice Address - Phone:360-988-2641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA274314D101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool