Provider Demographics
NPI:1679818488
Name:WAKEMAN, MARGARET MADDUX (RN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MADDUX
Last Name:WAKEMAN
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 1:1418 NW 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-5237
Mailing Address - Country:US
Mailing Address - Phone:206-252-1007
Mailing Address - Fax:206-743-3106
Practice Address - Street 1:1418 NW 65TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5237
Practice Address - Country:US
Practice Address - Phone:206-252-1007
Practice Address - Fax:206-743-3106
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00105278163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse