Provider Demographics
NPI:1639219827
Name:GRINDSTAFF, MICHELE (ND)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:GRINDSTAFF
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21827 76TH AVE W STE 201
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7981
Mailing Address - Country:US
Mailing Address - Phone:206-803-1045
Mailing Address - Fax:800-905-2197
Practice Address - Street 1:21827 76TH AVE W STE 201
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7981
Practice Address - Country:US
Practice Address - Phone:206-803-1045
Practice Address - Fax:800-905-2197
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT1466175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath