Provider Demographics
NPI:1134992977
Name:CROSBY, MICHAEL J (DACM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:CROSBY
Suffix:
Gender:M
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:794 6TH ST S FL 1
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6715
Mailing Address - Country:US
Mailing Address - Phone:425-753-2540
Mailing Address - Fax:
Practice Address - Street 1:794 6TH ST S FL 1
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6715
Practice Address - Country:US
Practice Address - Phone:425-753-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61474959171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist