MEDICARE: MR. MICHEL MARTIN COURET RN, MSN, ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN00137082	WA
2	363LF0000X	Family Nurse Practitioner	AP30005767	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	310608	OTHER	WA	STATE L&I

General Provider Information

NPI Number	:	1699768648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHEL MARTIN COURET RN, MSN, ARNP

Provider Business Mailing Address
First Line	:	4550 FAUNTLEROY WAY SW STE 100
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3471
Country	:	US
Telephone Number	:	206-933-1041
Fax Number	:	206-933-1047

Provider Business Practice Location Address
First Line	:	4550 FAUNTLEROY WAY SW STE 100
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3471
Country	:	US
Telephone Number	:	206-933-1041
Fax Number	:	206-933-1047

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	03/16/2021

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