Provider Demographics
NPI:1225539158
Name:GOLAN, MAYA GABRIELLE (ARNP)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:GABRIELLE
Last Name:GOLAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5371
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5005
Mailing Address - Country:US
Mailing Address - Phone:206-987-2114
Mailing Address - Fax:206-987-2651
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:M/S OB.8.412
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2114
Practice Address - Fax:206-987-2651
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60742851163W00000X
WAAP60755367363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse