Provider Demographics
NPI:1972796597
Name:MAAS, JOHN R
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:MAAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 KERN WAY STE B
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7805
Mailing Address - Country:US
Mailing Address - Phone:509-248-0933
Mailing Address - Fax:509-575-4763
Practice Address - Street 1:3810 KERN WAY STE B
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7805
Practice Address - Country:US
Practice Address - Phone:509-248-0933
Practice Address - Fax:509-575-4763
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA00045688237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist