Provider Demographics
NPI:1871876359
Name:MOY, MICHELLE (ARNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MOY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 BELMONT AVE
Mailing Address - Street 2:302
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-8300
Mailing Address - Country:US
Mailing Address - Phone:510-435-9196
Mailing Address - Fax:
Practice Address - Street 1:16 ROY ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4018
Practice Address - Country:US
Practice Address - Phone:206-281-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60186027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily