Healthcare Provider Details

I. General information

NPI: 1235973165
Provider Name (Legal Business Name): LUCY MAHER DNP, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1442 19TH AVE
SEATTLE WA
98122-2853
US

IV. Provider business mailing address

1442 19TH AVE
SEATTLE WA
98122-2853
US

V. Phone/Fax

Practice location:
  • Phone: 206-858-3166
  • Fax:
Mailing address:
  • Phone: 206-858-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP70067844
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61206651
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR-RN-LIC-217203
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: