Individual
MICHAEL A PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 814-6435
Mailing address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00136464
WA
363L00000X
Nurse Practitioner
Primary
AP60949011
WA
363LF0000X
Family Nurse Practitioner
AP60949011
WA
Other
Enumeration date
01/05/2019
Last updated
07/19/2019
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