Provider Demographics
NPI:1255090478
Name:ARENSON, MICHAEL JOSEPH (RN)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:ARENSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 TACOMA AVE S STE 305
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-1903
Mailing Address - Country:US
Mailing Address - Phone:253-396-5800
Mailing Address - Fax:
Practice Address - Street 1:737 FAWCETT AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-5503
Practice Address - Country:US
Practice Address - Phone:253-396-5800
Practice Address - Fax:253-383-5548
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61039456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse