Provider Demographics
NPI:1902070436
Name:ONEILL, MICHELE ELIZABETH (MICHELE ONEILL LMP)
Entity Type:Individual
Prefix:MISS
First Name:MICHELE
Middle Name:ELIZABETH
Last Name:ONEILL
Suffix:
Gender:F
Credentials:MICHELE ONEILL LMP
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:ONEILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MICHELE ONEILL LMP
Mailing Address - Street 1:409 RAINBOW PLACE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-9829
Mailing Address - Country:US
Mailing Address - Phone:206-604-1855
Mailing Address - Fax:360-863-2131
Practice Address - Street 1:409 RAINBOW PL
Practice Address - Street 2:409 RAINBOW PLACE
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1218
Practice Address - Country:US
Practice Address - Phone:206-604-1855
Practice Address - Fax:360-863-2131
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016315173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist