Provider Demographics
NPI:1871816124
Name:SONNTAG, MICHELE (PHD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:SONNTAG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16917 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-4917
Mailing Address - Country:US
Mailing Address - Phone:206-819-3611
Mailing Address - Fax:
Practice Address - Street 1:16917 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-4917
Practice Address - Country:US
Practice Address - Phone:206-819-3611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602569914374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula