Provider Demographics
NPI:1144063769
Name:MAUE, MADELYN PAIGE
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:PAIGE
Last Name:MAUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 N 10TH PL APT 2341
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5664
Mailing Address - Country:US
Mailing Address - Phone:616-443-8977
Mailing Address - Fax:
Practice Address - Street 1:1035 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4604
Practice Address - Country:US
Practice Address - Phone:425-688-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61401482163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient