Healthcare Provider Details

I. General information

NPI: 1801430350
Provider Name (Legal Business Name): MAUREEN ANN ESGET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 ANDERSON DR
ABERDEEN WA
98520-1006
US

IV. Provider business mailing address

1006 N H ST
ABERDEEN WA
98520-2521
US

V. Phone/Fax

Practice location:
  • Phone: 360-537-6032
  • Fax:
Mailing address:
  • Phone: 360-537-6032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number60047492
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: