Provider Demographics
NPI:1699206243
Name:MCGRAW, MAGGIE MAY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:MAY
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:MAGGIE
Other - Middle Name:MAY
Other - Last Name:MCGOWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16109 NE 31ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642
Mailing Address - Country:US
Mailing Address - Phone:360-857-9899
Mailing Address - Fax:
Practice Address - Street 1:410 E 20TH STREET
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663
Practice Address - Country:US
Practice Address - Phone:360-857-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW608957711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical