1376528059 NPI number — MRS. MICHELLE M ZIEGLER MPT

Table of content: THOMAS P. NIEBUR LCPC, LMFT, CSAT (NPI 1437172103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376528059 NPI number — MRS. MICHELLE M ZIEGLER MPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIEGLER
Provider First Name:
MICHELLE
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376528059
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 TUMWATER BLVD SE STE 113
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUMWATER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98501-6422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-528-3300
Provider Business Mailing Address Fax Number:
360-528-8162

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2964 LIMITED LN NW STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLYMPIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98502-4577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-704-7276
Provider Business Practice Location Address Fax Number:
360-704-7277
Provider Enumeration Date:
12/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT00007656 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8344814 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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