Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael R Komanetz, MSNARNP

Individual provider Family Nurse Practitioner · NPI 1306216734

Michael R Komanetz, MSNARNP is a Nurse Practitioner in Snoqualmie, Washington. Qualified in 2015, 11 years ago. Practices with Sanford Medical Center Fargo, a 1,212-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
11
Licensed in
WA
In the registry since
2015
Specialties on file
2

Practice location Address checks out

37624 SE Fury St Ste 101
Snoqualmie, WA 98065-9680
Phone: (425) 888-2016
Fax: (206) 320-5170
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP60577565 (WA)
Nurse Practitioner Taxonomy 363L00000X · Licence AP60577565 (WA)

Record details

NPI number1306216734
Entity typeIndividual (Type 1)
GenderMale
Credentials MSNARNP
Sole proprietorNo
NPI enumeratedSeptember 28, 2015
Last updated in NPPESOctober 7, 2020
Certification dateOctober 7, 2020
Mailing addressPo Box 25608, Salt Lake City, UT 84125-0608

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Sanford Medical Center Fargo — 1212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Snoqualmie