Provider Demographics
NPI:1912968678
Name:SINN, MICHELLE NELSON (MA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:NELSON
Last Name:SINN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16918 MCRAE RD NW
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8087
Mailing Address - Country:US
Mailing Address - Phone:360-652-0510
Mailing Address - Fax:
Practice Address - Street 1:2702 ROCKEFELLER AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3523
Practice Address - Country:US
Practice Address - Phone:425-258-2955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00000959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist