Provider Demographics
NPI:1952312472
Name:MAURER, NANCY LOUISE (LMP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LOUISE
Last Name:MAURER
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 1:6319 82ND ST NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-3393
Mailing Address - Country:US
Mailing Address - Phone:425-941-3128
Mailing Address - Fax:360-629-6042
Practice Address - Street 1:9522 271ST ST NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-8095
Practice Address - Country:US
Practice Address - Phone:360-629-0800
Practice Address - Fax:360-629-6042
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60255520811225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist