Provider Demographics
NPI:1881204204
Name:DILL, MICHEL AIDA
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:AIDA
Last Name:DILL
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 1:7810 FAIRWAY AVE SE UNIT 1202
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9046
Mailing Address - Country:US
Mailing Address - Phone:206-910-8105
Mailing Address - Fax:
Practice Address - Street 1:7810 FAIRWAY AVE SE UNIT 1202
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9046
Practice Address - Country:US
Practice Address - Phone:206-910-8105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-01
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA11256171R00000X
WA52616171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter