MEDICARE: MAYRA MUIR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LP70020642	WA
2	101YM0800X	Mental Health Counselor		WA

General Provider Information

NPI Number	:	1194290957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYRA MUIR

Provider Business Mailing Address
First Line	:	1701 18TH AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-4317
Country	:	US
Telephone Number	:	206-731-7210
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 SW HOLDEN ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126
Country	:	UM
Telephone Number	:	206-933-7199
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2018
Last Update Date	:	12/18/2025

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Directions to “ MAYRA MUIR ” Practice Location

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