Provider Demographics
NPI:1205854411
Name:CUNNINGHAM, MARGARET LEA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:LEA
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:LEA
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:20048 95TH PL NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-2303
Mailing Address - Country:US
Mailing Address - Phone:425-481-9399
Mailing Address - Fax:425-481-9399
Practice Address - Street 1:20048 95TH PL NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2303
Practice Address - Country:US
Practice Address - Phone:425-481-9399
Practice Address - Fax:425-481-9399
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00036530101Y00000X
WAPY00003260103T00000X
SD361103T00000X
WARN00054419163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6551252Medicaid
SD6551252Medicaid