Individual
MS. ALIDA DIANE MAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
15 FAIRVIEW RD, GRAYS RIVER, WA 98621-9724
(360) 465-2392
Mailing address
15 FAIRVIEW RD, GRAYS RIVER, WA 98621-9724
(360) 465-2392
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098102
—
OR
Enumeration date
01/15/2007
Last updated
07/09/2007
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