Cannon, Michele M
Cannon, Michele M is an individual health care provider with primary practice located at 1530 S Union Ave Ste 1 , Tacoma WA 98405-1954. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Cannon, Michele M can be contacted via phone (253) 759-3333.Contact Information
Primary practice address
1530 S Union Ave Ste 1
Tacoma WA 98405-1954
Phone: (253) 759-3333
Fax: (253) 759-1415
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00039058 | Washington |
Profile Details
| NPI number | 1144522459 |
|---|---|
| LBN Legal business name | Cannon, Michele M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 19th, 2010 |
| Last updated | Nov 11th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144522459 | NPPES |
| Washington | MEDICAID | 202849 |
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