Healthcare Provider Details
I. General information
NPI: 1659488948
Provider Name (Legal Business Name): MICHELE LYNN ARNOLD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/24/2006
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1750 112TH AVE NE SUITE D258
BELLEVUE WA
98004-3752
US
IV. Provider business mailing address
PO BOX 25608
SALT LAKE CITY UT
84125-0608
US
V. Phone/Fax
- Phone: 425-498-2272
- Fax: 425-498-2334
- Phone: 206-320-4476
- Fax: 206-568-7043
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 22490 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081S0010X |
| Taxonomy | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | MD60344481 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081N0008X |
| Taxonomy | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | MD60344481 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: