Individual
MIRACLE ISRAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19116 33RD AVE W, LYNNWOOD, WA 98036-4706
(425) 712-7900
(425) 712-7905
Mailing address
19116 33RD AVE W, LYNNWOOD, WA 98036-4706
(425) 712-7900
(425) 712-7905
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60490415
WA
363L00000X
Nurse Practitioner
Primary
AP61081985
WA
Other
Enumeration date
02/25/2020
Last updated
03/30/2021
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