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:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1616 W WELLESLEY AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1413
Mailing Address - Country:US
Mailing Address - Phone:509-992-2562
Mailing Address - Fax:509-984-4526
Practice Address - Street 1:1616 W WELLESLEY AVE STE C
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-1413
Practice Address - Country:US
Practice Address - Phone:509-957-0097
Practice Address - Fax:509-984-4526
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60186765363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily