Healthcare Provider Details

I. General information

NPI: 1871213876
Provider Name (Legal Business Name): MICHELLE BYKONEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 N 100TH ST
SEATTLE WA
98133-9302
US

IV. Provider business mailing address

506 N 100TH ST
SEATTLE WA
98133-9302
US

V. Phone/Fax

Practice location:
  • Phone: 406-465-3856
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61667135
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: