Provider Demographics
NPI:1992886790
Name:NEWCOMER, MICHELE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:MARIE
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65055
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665
Mailing Address - Country:US
Mailing Address - Phone:360-750-0250
Mailing Address - Fax:360-750-0253
Practice Address - Street 1:3303 NE MINNEHAHA ST
Practice Address - Street 2:SUITE C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663
Practice Address - Country:US
Practice Address - Phone:360-750-0250
Practice Address - Fax:360-750-0253
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034005111N00000X, 111NN1001X
OR273264111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
V02124Medicare UPIN
WAG8808675Medicare PIN