Provider Demographics
NPI:1225470446
Name:DEFILIPPO, MICHAEL M (ARNP)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:DEFILIPPO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-0253
Mailing Address - Country:US
Mailing Address - Phone:360-328-1142
Mailing Address - Fax:360-698-5048
Practice Address - Street 1:221 W PATISON ST STE 203A
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339-9751
Practice Address - Country:US
Practice Address - Phone:650-753-1193
Practice Address - Fax:360-369-6722
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60511408363LF0000X, 363LP0808X
WARN60511407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily