Provider Demographics
NPI:1962979542
Name:MYETT, MICHAEL (LMHCA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:MYETT
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 E B ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-1131
Mailing Address - Country:US
Mailing Address - Phone:717-372-6057
Mailing Address - Fax:
Practice Address - Street 1:2002 156TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3827
Practice Address - Country:US
Practice Address - Phone:717-372-6057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60901274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health