Provider Demographics
NPI:1619387180
Name:VEAGUE, MAIA (DC)
Entity Type:Individual
Prefix:DR
First Name:MAIA
Middle Name:
Last Name:VEAGUE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 EASTLAKE AVE E
Mailing Address - Street 2:333
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3366
Mailing Address - Country:US
Mailing Address - Phone:206-420-7926
Mailing Address - Fax:206-458-6072
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:333
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:206-420-7926
Practice Address - Fax:206-458-6072
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60459461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor