Provider Demographics
NPI:1952518672
Name:GALLOWAY, MICHAEL ALAN (MED, MA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:GALLOWAY
Suffix:
Gender:M
Credentials:MED, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 NE 55TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2262
Mailing Address - Country:US
Mailing Address - Phone:206-526-7945
Mailing Address - Fax:206-527-2978
Practice Address - Street 1:4026 NE 55TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2262
Practice Address - Country:US
Practice Address - Phone:206-526-7945
Practice Address - Fax:206-527-2978
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001058106H00000X
WALH00004886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health