Individual
MS. MAXINE CERAOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
933 E 1ST ST, PORT ANGELES, WA 98362-4012
(360) 452-7891
(360) 452-8087
Mailing address
240 W FRONT ST STE A, PORT ANGELES, WA 98362-2609
(360) 452-7891
(360) 452-8087
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
AP61167344
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
417174
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61167344
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2211667
—
WA
Enumeration date
12/31/2020
Last updated
10/02/2023
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