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Individual

MR. THEODORE THOMAS MAIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.M.P.

Contact information

Practice address
210 E MCLOUGHLIN BLVD, VANCOUVER, WA 98663-3369
(360) 718-7277
Mailing address
1815 NE 90TH CIR, VANCOUVER, WA 98665-9157
(503) 577-7839

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60022321
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0241664
LABOR AND INDUSTRIES
WA
Enumeration date
10/16/2008
Last updated
06/07/2010
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