Individual
MISA PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN - MIDWIFE
Contact information
Practice address
1959 NE PACIFIC ST # 350, SEATTLE, WA 98195-1874
(206) 598-3300
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
AP61304134
WA
367A00000X
Advanced Practice Midwife
Primary
AP61304134
WA
Other
Enumeration date
05/25/2022
Last updated
08/25/2022
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