Individual
MICAELA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP, FNP
Contact information
Practice address
1221 MADISON ST, STE 1020, SEATTLE, WA 98104-1380
(206) 215-2658
(206) 991-2363
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN61238375
WA
363L00000X
Nurse Practitioner
Primary
AP61238582
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2214784
—
WA
Enumeration date
05/22/2020
Last updated
12/02/2022
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