Provider Demographics
NPI:1972935443
Name:WARD, MAUREEN ELISABETH (LMP)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ELISABETH
Last Name:WARD
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 1:204 S 348TH ST
Mailing Address - Street 2:STE. 3
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7041
Mailing Address - Country:US
Mailing Address - Phone:253-838-2302
Mailing Address - Fax:
Practice Address - Street 1:204 S 348TH ST
Practice Address - Street 2:STE. 3
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7041
Practice Address - Country:US
Practice Address - Phone:253-838-2302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60303834225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist