Provider Demographics
NPI:1902982309
Name:ARONOW, MICHELLE RAYE (RN, BSN, MN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RAYE
Last Name:ARONOW
Suffix:
Gender:F
Credentials:RN, BSN, MN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:RAYE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1175 CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3300
Mailing Address - Country:US
Mailing Address - Phone:509-943-4103
Mailing Address - Fax:509-946-7206
Practice Address - Street 1:1175 CARONDELET DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3300
Practice Address - Country:US
Practice Address - Phone:509-943-4103
Practice Address - Fax:509-946-7206
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00117248163WP0808X
WAAP30005779363LP0808X
OR201400898NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA319100600Medicare ID - Type UnspecifiedGROUP #