Provider Demographics
NPI:1457966871
Name:MATTAR, MAGDA MAURICE
Entity Type:Individual
Prefix:MRS
First Name:MAGDA
Middle Name:MAURICE
Last Name:MATTAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15820 36TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4749
Mailing Address - Country:US
Mailing Address - Phone:206-335-9175
Mailing Address - Fax:
Practice Address - Street 1:15820 36TH AVE SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-4749
Practice Address - Country:US
Practice Address - Phone:206-335-9175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter