Provider Demographics
NPI:1851840953
Name:CUTTING, MICHAEL DAVID JR (LMP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DAVID
Last Name:CUTTING
Suffix:JR
Gender:M
Credentials:LMP
Other - Prefix:
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Mailing Address - Street 1:1220 BOYLSTON AVE APT 404
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2850
Mailing Address - Country:US
Mailing Address - Phone:808-348-5206
Mailing Address - Fax:
Practice Address - Street 1:2014 E MADISON ST STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2965
Practice Address - Country:US
Practice Address - Phone:206-726-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60477090225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist