Provider Demographics
NPI:1609029479
Name:SEGAWA, MARIA J (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:J
Last Name:SEGAWA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:J
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:955 POWELL AVE.
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-9208
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:126 AUBURN AVE.
Practice Address - Street 2:#300
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5057
Practice Address - Country:US
Practice Address - Phone:253-735-0166
Practice Address - Fax:253-833-8987
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00134168163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse