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Individual

DR. MICHAEL AZIZ MISHALANIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
401 S 43RD ST, SUITE 110, RENTON, WA 98055-5404
(425) 226-5656
(425) 271-1488
Mailing address
401 S 43RD ST, SUITE 110, RENTON, WA 98055-5404
(425) 226-5656
(425) 271-1488

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0017065
WA
213ES0000X
Sports Medicine Podiatrist
0017065
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
0017065
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0017065
GRP 0056910 WORKERS COMP
WA
01
029382001
CIGNA MEDICARE
WA
01
192061900
US DEPT OF LABOR
01
911337710
PREMERA
WA
01
MI2246
GRP 5229 REGENCE
WA
Enumeration date
10/25/2005
Last updated
04/24/2017
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