Provider Demographics
NPI:1023709110
Name:MICHILENA, MARIA PILAR (ARNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:PILAR
Last Name:MICHILENA
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 1:4596 ORCAS WAY
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9577
Mailing Address - Country:US
Mailing Address - Phone:360-815-2490
Mailing Address - Fax:
Practice Address - Street 1:4596 ORCAS WAY
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9577
Practice Address - Country:US
Practice Address - Phone:360-815-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003568363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health