Provider Demographics
NPI:1841211547
Name:MAXWELL, BARBARA J (ARNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W FRONT ST STE A
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-2609
Mailing Address - Country:US
Mailing Address - Phone:360-452-7891
Mailing Address - Fax:360-452-8087
Practice Address - Street 1:240 W FRONT ST STE A
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-2609
Practice Address - Country:US
Practice Address - Phone:360-452-7891
Practice Address - Fax:360-452-8087
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1020227Medicaid
WA7082563Medicaid
WA7082563Medicaid