Provider Demographics
NPI:1851980528
Name:MORRISON, MIKESHIA
Entity Type:Individual
Prefix:
First Name:MIKESHIA
Middle Name:
Last Name:MORRISON
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 1:643 147TH PL NE APT C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-7710
Mailing Address - Country:US
Mailing Address - Phone:425-269-0504
Mailing Address - Fax:
Practice Address - Street 1:643 147TH PL NE APT C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-7710
Practice Address - Country:US
Practice Address - Phone:425-269-0504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60742378376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide