Provider Demographics
NPI:1396310835
Name:GUIMARAES, MIKAELA (ARNP)
Entity type:Individual
Prefix:DR
First Name:MIKAELA
Middle Name:
Last Name:GUIMARAES
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 1:4975 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-9699
Mailing Address - Country:US
Mailing Address - Phone:206-747-9876
Mailing Address - Fax:
Practice Address - Street 1:SNOHOMISH FAMILY MEDICINE
Practice Address - Street 2:629 AVENUE D
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290
Practice Address - Country:US
Practice Address - Phone:360-568-1554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61149075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily