Basic Information
| Provider Information | |||||||||
| NPI: | 1720545577 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUEING | ||||||||
| FirstName: | MICHELE | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19702 WINESAP RD | ||||||||
| Address2: | |||||||||
| City: | BOTHELL | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980127037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254864568 | ||||||||
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| Practice Location | |||||||||
| Address1: | 811 MADISON ST | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982034543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252124200 | ||||||||
| FaxNumber: | 4252124201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2019 | ||||||||
| LastUpdateDate: | 02/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 00039442 | WA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.