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Individual
MICHAEL J. GRODESKY
Active
Individual
MICHAEL J. GRODESKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00154484
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
AP30006742
WA
Other
Enumeration date
07/17/2006
Last updated
10/11/2007
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