Provider Demographics
NPI:1285970046
Name:DONOHUE, MICHELE CHRISTINE (PT)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:CHRISTINE
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14015 62ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8607
Mailing Address - Country:US
Mailing Address - Phone:253-530-1100
Mailing Address - Fax:253-530-1085
Practice Address - Street 1:14015 62ND AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8607
Practice Address - Country:US
Practice Address - Phone:253-530-1100
Practice Address - Fax:253-530-1085
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00008507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist