Provider Demographics
NPI:1225572480
Name:HAGI-MAYOW, MARIAN (RN/BSN)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:HAGI-MAYOW
Suffix:
Gender:F
Credentials:RN/BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14111 BEVERLY PARK RD
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-3919
Mailing Address - Country:US
Mailing Address - Phone:425-444-3039
Mailing Address - Fax:
Practice Address - Street 1:14111 BEVERLY PARK RD
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-3919
Practice Address - Country:US
Practice Address - Phone:425-444-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00174870163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse