Provider Demographics
NPI:1467040873
Name:SHAHBAAZ, MARIA A (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:SHAHBAAZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21270 SE 289TH WAY
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-6855
Mailing Address - Country:US
Mailing Address - Phone:425-321-7984
Mailing Address - Fax:
Practice Address - Street 1:21270 SE 289TH WAY
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-6855
Practice Address - Country:US
Practice Address - Phone:425-321-7984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-02
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60913214163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse