Provider Demographics
NPI:1679321590
Name:MCLEAN, MICHAELA LEA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MICHAELA
Middle Name:LEA
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4593 ALTADENA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3321
Mailing Address - Country:US
Mailing Address - Phone:858-789-6822
Mailing Address - Fax:
Practice Address - Street 1:25615 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7609
Practice Address - Country:US
Practice Address - Phone:253-872-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist