Individual
MICHAEL R KOMANETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN ARNP
Contact information
Practice address
37624 SE FURY ST, STE 101, SNOQUALMIE, WA 98065-9680
(425) 888-2016
(206) 320-5170
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60577565
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60577565
WA
Other
Enumeration date
09/28/2015
Last updated
10/07/2020
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