Provider Demographics
NPI:1316207707
Name:MAUGHAN, DEEANNA K (MD)
Entity Type:Individual
Prefix:
First Name:DEEANNA
Middle Name:K
Last Name:MAUGHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19723 HIGHWAY 99 STE G
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6080
Mailing Address - Country:US
Mailing Address - Phone:833-411-5469
Mailing Address - Fax:855-459-3020
Practice Address - Street 1:19723 HIGHWAY 99 STE G
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6080
Practice Address - Country:US
Practice Address - Phone:425-292-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60550630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine