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General NPI Number Information
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NPI Number | 1811486228
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Entity Type | Individual
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Provider Name | GREGORY IMAFIDON ARNP
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Gender | Male
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 521 2ND PL N STE 11-103
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City | KENT
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State | WA
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Zip | 98032-4537
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Country | US
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Telephone | 425-690-3491
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Fax | 425-690-9091
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Provider Business Mailing Address
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Address Line | 521 2ND PL N STE 11-103
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City | KENT
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State | WA
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Zip | 98032-4537
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Country | US
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Telephone | 425-690-3491
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Fax | 425-690-9091
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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 | AP61288019
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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 | AP137759
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F04180510
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61288019
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License Number State | WA
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