Healthcare Provider Details

I. General information

NPI: 1649314121
Provider Name (Legal Business Name): MICHELLE L KARUNA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 43RD AVE S
SEATTLE WA
98118-1204
US

IV. Provider business mailing address

4131 43RD AVE S
SEATTLE WA
98118-1204
US

V. Phone/Fax

Practice location:
  • Phone: 206-515-5811
  • Fax:
Mailing address:
  • Phone: 206-515-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00048760
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number00048760
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: