Provider Demographics
NPI:1427384429
Name:NAIR, MICHI E (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHI
Middle Name:E
Last Name:NAIR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MADISON ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-4308
Mailing Address - Country:US
Mailing Address - Phone:206-386-6266
Mailing Address - Fax:206-386-2844
Practice Address - Street 1:1101 MADISON ST STE 1400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-4308
Practice Address - Country:US
Practice Address - Phone:206-386-6266
Practice Address - Fax:206-386-2844
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60107990363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1427384429Medicaid