Michelle Ann Lu
Individual provider Active NPI Homemaker · Portland, OR
NPI 1699190751 · NPPES record last updated Feb 26, 2014
Key facts
- NPI
- 1699190751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- License
- NAR.NA.60451427 (WA)
- Practice address
- 11124 NE Halsey St # 572
Portland, OR 97220-2021 - Phone
- (888) 354-2758
- NPI assigned
- Feb 26, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NAR.NA.60451427 | WA | MD | Homemaker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | NAR.NA.60451427 | WA | Yes |
Addresses
Primary practice location
11124 NE Halsey St # 572
Portland, OR 97220-2021
Mailing address
11124 NE Halsey St # 572
Portland, OR 97220-2021
Other names
- Michelle Ann Suazo Gamulo
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.