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NPI Code Detail

MEDICARE: MICHELE NETH DICKSON ARNP

MEDICARE: MICHELE NETH DICKSON ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN00105798WA
2363LW0102XWomen's Health Nurse PractitionerAP30003195WA
3363LF0000XFamily Nurse PractitionerMD0118364OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1500018475OTHERWAMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619957990
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE NETH DICKSON ARNP
Provider Business Mailing Address
First Line : 1498 SE TECH CENTER PL STE 240
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-5508
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12123 SW 69TH AVE
Second Line :
City : TIGARD
State : OR
Zip : 97223-8514
Country : US
Telephone Number : 971-708-7600
Fax Number : 971-371-5230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 07/17/2023

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Directions to “ MICHELE NETH DICKSON ARNP” Practice Location

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