Provider Demographics
NPI:1982909198
Name:WOON, MAUREEN A (MSE)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:A
Last Name:WOON
Suffix:
Gender:F
Credentials:MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 N DOLARWAY RD
Mailing Address - Street 2:203
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-8392
Mailing Address - Country:US
Mailing Address - Phone:509-925-1840
Mailing Address - Fax:509-925-1840
Practice Address - Street 1:1206 N DOLARWAY RD
Practice Address - Street 2:203
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-8392
Practice Address - Country:US
Practice Address - Phone:509-925-1840
Practice Address - Fax:509-925-1840
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60219078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health