Individual
MAYA ITZA KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
629 AVENUE D STE 1, SNOHOMISH, WA 98290-2303
(360) 568-1554
(360) 568-1722
Mailing address
2912 N TALMAN AVE UNIT 1, CHICAGO, IL 60618-7815
(937) 631-2393
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036154635
IL
207Q00000X
Family Medicine Physician
12158
SD
207Q00000X
Family Medicine Physician
MD203985
OR
207Q00000X
Family Medicine Physician
Primary
MD61335254
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0460399
LABOR AND INDUSTRIES
WA
05
—
2221896
—
WA
Enumeration date
03/22/2017
Last updated
01/08/2026
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