Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DE00005017 | WA |
NPI | 1033440201 |
---|---|
Provider Name | Maurine Machugh |
First Address | Kirkland, WA 98034-3027 |
Second Address | Kirkland, WA 98034-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2010 |
Last Update Date | 27/01/2010 |