Provider Demographics
NPI:1811442536
Name:LEARY-CHANG, MICHELLE (NMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:LEARY-CHANG
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MARIE
Other - Last Name:LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:608 W MERCER PL
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3808
Mailing Address - Country:US
Mailing Address - Phone:206-418-9937
Mailing Address - Fax:
Practice Address - Street 1:13353 BEL RED RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2329
Practice Address - Country:US
Practice Address - Phone:425-433-4294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath