Provider Demographics
NPI:1003584053
Name:HAYS, MAGDALYNN (CN)
Entity Type:Individual
Prefix:
First Name:MAGDALYNN
Middle Name:
Last Name:HAYS
Suffix:
Gender:F
Credentials:CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 NE 20TH ST APT 83
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5553
Mailing Address - Country:US
Mailing Address - Phone:360-903-0080
Mailing Address - Fax:
Practice Address - Street 1:1409 FRANKLIN ST STE 103
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2860
Practice Address - Country:US
Practice Address - Phone:360-787-3615
Practice Address - Fax:833-324-3373
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU61196416133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist