Healthcare Provider Details

I. General information

NPI: 1215716675
Provider Name (Legal Business Name): ARINA ALTUHOV FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12728 19TH AVE SE
EVERETT WA
98208-6675
US

IV. Provider business mailing address

1728 W MARINE DR STE 110
EVERETT WA
98201-2094
US

V. Phone/Fax

Practice location:
  • Phone: 425-317-8025
  • Fax:
Mailing address:
  • Phone: 425-317-8025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP70148010
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10063068
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: