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General NPI Number Information
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NPI Number | 1356555098
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Entity Type | Organization
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Legal Business Name | MICHAEL A. MISHALANIE, DPM PS
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 433 SW 41ST ST
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City | RENTON
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State | WA
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Zip | 98057-4926
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Country | US
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Telephone | 425-226-5656
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Fax | 425-271-1488
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Provider Business Mailing Address
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Address Line | 433 SW 41ST ST
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City | RENTON
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State | WA
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Zip | 98057-4926
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Country | US
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Telephone | 425-226-5656
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Fax | 425-271-1488
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Authorized Official
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Title or Position | PODIATRIST, OWNER
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Name | MICHAEL A MISHALANIE
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Credential | DPM
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Telephone | 425-226-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number |
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License Number State |
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