Individual
MR. MICHAEL KEEGAN HUNTSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
875 WESLEY ST STE 230, ARLINGTON, WA 98223-1668
(360) 435-6097
(360) 435-1871
Mailing address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 814-6451
(360) 445-8592
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
OA61091541
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/03/2020
Last updated
11/02/2021
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