Provider Demographics
NPI:1801810908
Name:SEELIG, MICHELLE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SEELIG
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 1:2200 6TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1817
Mailing Address - Country:US
Mailing Address - Phone:206-456-2500
Mailing Address - Fax:206-589-6900
Practice Address - Street 1:2200 6TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1817
Practice Address - Country:US
Practice Address - Phone:206-456-2500
Practice Address - Fax:206-589-6900
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79449207Q00000X
WAMD00046907207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A794490Medicaid
CAH86980Medicare UPIN
CA00A794490Medicaid