Provider Demographics
NPI:1336602762
Name:SWAI, MAUA WINGI (ARNP, FNP-C, PMHNP)
Entity type:Individual
Prefix:
First Name:MAUA
Middle Name:WINGI
Last Name:SWAI
Suffix:
Gender:F
Credentials:ARNP, FNP-C, PMHNP
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 7023
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-0700
Mailing Address - Country:US
Mailing Address - Phone:253-470-8078
Mailing Address - Fax:253-248-0139
Practice Address - Street 1:28002 STATE ROUTE 410 E STE 5
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-7516
Practice Address - Country:US
Practice Address - Phone:253-470-8078
Practice Address - Fax:253-248-0139
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60932756207Q00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine