Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michelle Marie Fodczuk

Individual provider Case Management Registered Nurse · NPI 1417642562

Michelle Marie Fodczuk is a Case Management Registered Nurse in Bonney Lake, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2023
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Practice location Address checks out

4926 N Island Dr E
Bonney Lake, WA 98391-8608
Phone: (425) 365-6968
Fax: (425) 386-5065
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Management Registered Nurse (primary) Taxonomy 163WC0400X · Licence RN0119006 (WA)

Record details

NPI number1417642562
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 5, 2023
Last updated in NPPESApril 5, 2023
Certification dateApril 5, 2023

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