Provider Demographics
NPI:1689973232
Name:MITTON, ARIELLE (MD)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:MITTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:
Other - Last Name:FLAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-304-8431
Mailing Address - Fax:
Practice Address - Street 1:9709 3RD AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2062
Practice Address - Country:US
Practice Address - Phone:425-339-5422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270620207R00000X
CAA128905207R00000X
390200000X
WAMD61346086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program