Provider Demographics
NPI:1073722641
Name:MAUAD, ANNE KATHLEEN (LMP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:KATHLEEN
Last Name:MAUAD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 DEWEY PL E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4830
Mailing Address - Country:US
Mailing Address - Phone:206-619-8245
Mailing Address - Fax:
Practice Address - Street 1:311 DEWEY PL E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4830
Practice Address - Country:US
Practice Address - Phone:206-619-8245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005638174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist