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General NPI Number Information
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NPI Number | 1982694501
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Entity Type | Individual
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Provider Name | MICHAEL AZIZ MISHALANIE DPM
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 401 S 43RD ST SUITE 110
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City | RENTON
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State | WA
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Zip | 98055-5404
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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 | 401 S 43RD ST SUITE 110
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City | RENTON
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State | WA
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Zip | 98055-5404
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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 |
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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 | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 0017065
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number | 0017065
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0017065
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License Number State | WA
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