Provider Demographics
NPI:1821166018
Name:HILL, MAUREEN GAIL (LMP)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:GAIL
Last Name:HILL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SANDY LN
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-8949
Mailing Address - Country:US
Mailing Address - Phone:360-807-0532
Mailing Address - Fax:
Practice Address - Street 1:221 N TOWER ST
Practice Address - Street 2:SUITE 311
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-4309
Practice Address - Country:US
Practice Address - Phone:360-736-5889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012341174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0125506OtherLABOR & INDUSTRIES