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General NPI Number Information
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NPI Number | 1295250124
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Entity Type | Individual
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Provider Name | MICHAEL DURKIN NP-C
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Gender | Male
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 9502 176TH ST E
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City | PUYALLUP
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State | WA
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Zip | 98375-9300
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Country | US
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Telephone | 855-237-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 14624 72ND ST E APT 123
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City | SUMNER
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State | WA
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Zip | 98390-5518
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Country | US
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Telephone | 253-948-6979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60775676
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60775676
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License Number State | WA
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