Mark C Michael, PHD, CGP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001182 Issued in WA

Practice address

309 Federal Ave E
Ste a
Seattle, WA 98102-5416

Phone

(206) 324-8285

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2013 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508864166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 FEDERAL AVE E",
            "address_2": "STE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025416",
            "telephone_number": "206-324-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 FEDERAL AVE E",
            "address_2": "STE A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025416",
            "telephone_number": "206-324-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD, CGP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "MI-9953",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael R Harris DDS PS
• Michael Rediger Licsw Inc
• Michael S Cho DDS PS
• Joshua B Michael, MD
• Louisa P. Michael, ARNP, DNP
• Modupe Margaret Michael
• Scott T Michael, PH.D.
• Michaela Hagerty-Koller P.S.
• Anthony Michaels, LMP
• Dan Michaels, D.D.S.

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.