Provider Demographics
NPI:1851694673
Name:GUNDERSON, MICHELE LOUISE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LOUISE
Last Name:GUNDERSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20803 N HORSEMAN LN
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-6001
Mailing Address - Country:US
Mailing Address - Phone:099-922-5625
Mailing Address - Fax:
Practice Address - Street 1:20803 N HORSEMAN LN
Practice Address - Street 2:
Practice Address - City:COLBERT
Practice Address - State:WA
Practice Address - Zip Code:99005-6001
Practice Address - Country:US
Practice Address - Phone:509-992-2562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60186765363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner