Provider Demographics
NPI:1821545179
Name:ANNE MAURO, PLLC
Entity Type:Organization
Organization Name:ANNE MAURO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFTA
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURO
Authorized Official - Suffix:
Authorized Official - Credentials:MG60669377
Authorized Official - Phone:206-588-6094
Mailing Address - Street 1:121 LAKESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24848 24TH PL S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-4031
Practice Address - Country:US
Practice Address - Phone:206-588-6804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-03
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60669377261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)