Individual provider Active NPI

Michelle Brozick, LMP

  • Specialist
  • Edgewood, WA
National Provider Identifier
1477837342
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60232833 Issued in WA
Practice address
2908 Meridian Ave E Ste 101
Edgewood, WA 98371-2191
Phone
(253) 318-6570
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60232833 WA Primary

Addresses

Primary practice location

2908 Meridian Ave E Ste 101
Edgewood, WA 98371-2191

Mailing address

2908 Meridian Ave E Ste 101
Edgewood, WA 98371-2191
Phone (253) 318-6570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA60232833WAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1477837342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 MERIDIAN AVE E STE 101",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983712191",
            "telephone_number": "253-318-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 MERIDIAN AVE E STE 101",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983712191",
            "telephone_number": "253-318-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROZICK",
        "first_name": "MICHELLE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60232833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.