Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD00028443 | WA |
N | 207KA0200X | Allergist | MM069013 | MI |
NPI | 1548234743 |
---|---|
Provider Name | Mary C Maier |
First Address | Bremerton, WA 98310-3399 |
Second Address | Silverdale, WA 98383-8561 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 25/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0061MA | REGENCE (01) | |
130293185 | (05) | MI |
255307 | LABOR & INDUSTRIES (01) | WA |
8136343 | (05) | WA |
F16064 | (02) | MI |