Provider Demographics
NPI:1265562573
Name:HINATSU, MICHELE R (ARNP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:HINATSU
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 1:9725 3RD AVE NE STE 500
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2024
Mailing Address - Country:US
Mailing Address - Phone:206-527-1200
Mailing Address - Fax:
Practice Address - Street 1:9725 3RD AVE NE STE 500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2024
Practice Address - Country:US
Practice Address - Phone:206-527-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003078363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAHI5428OtherREGENCE RIDER SEATTLE
WA28865OtherREGENCE RIDER MT. VERNON
WA961884Medicaid
WAHI9328OtherREGENCE RIDER EVERETT
WA500007100OtherMEDCARE RAIL ROAD
WA5428HIOtherREGENCE RIDER REDMOND
WA500007097OtherMEDICARE RAIL ROAD
WAAB04322Medicare ID - Type UnspecifiedSEATTLE
WA500007097OtherMEDICARE RAIL ROAD
WAHI9328OtherREGENCE RIDER EVERETT
WAS55997Medicare UPIN