Individual
PEYTON ZAIN MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
605 INDEX AVENUE, INDEX, WA 98256
(360) 858-5487
Mailing address
PO BOX 253, INDEX, WA 98256-0253
(360) 858-5487
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
WDLB84T7F9SB
WA
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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