Provider Demographics
NPI:1457721987
Name:HUME, MAGGI (CPNP)
Entity Type:Individual
Prefix:
First Name:MAGGI
Middle Name:
Last Name:HUME
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 KENYON ST NW STE 10
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4578
Mailing Address - Country:US
Mailing Address - Phone:360-339-8466
Mailing Address - Fax:360-995-0050
Practice Address - Street 1:222 KENYON ST NW STE 10
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4578
Practice Address - Country:US
Practice Address - Phone:360-339-8466
Practice Address - Fax:360-995-0050
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-26
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAPN60596461363LP0200X
WAAP60596461363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics