Provider Demographics
NPI:1215511308
Name:MAHER, SAVANNAH (NBC-HWC)
Entity type:Individual
Prefix:MISS
First Name:SAVANNAH
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7512
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-0922
Mailing Address - Country:US
Mailing Address - Phone:253-307-5998
Mailing Address - Fax:
Practice Address - Street 1:23212 27TH AVE S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-8720
Practice Address - Country:US
Practice Address - Phone:253-307-5998
Practice Address - Fax:253-307-5998
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA-3252888