Individual
WENDY MIRONOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
16200 116TH AVE SE, RENTON, WA 98058-5200
(425) 400-1899
(425) 663-8000
Mailing address
955 POWELL AVE SW, RENTON, WA 98057-2908
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60867522
WA
363L00000X
Nurse Practitioner
Primary
AP60896870
WA
363LF0000X
Family Nurse Practitioner
AP60896870
WA
Other
Enumeration date
10/04/2018
Last updated
02/03/2025
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