Provider Demographics
NPI:1437517927
Name:MAKI, CAROLINE MICHELLE
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MICHELLE
Last Name:MAKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 LOYOLA ST NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5451
Mailing Address - Country:US
Mailing Address - Phone:360-528-0383
Mailing Address - Fax:
Practice Address - Street 1:1122 LOYOLA ST NE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-5451
Practice Address - Country:US
Practice Address - Phone:360-528-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60383516163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient