Individual
MAITAI TIUMALU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1210 SW 136TH ST, BURIEN, WA 98166-1214
(206) 915-7393
Mailing address
3001 S 288TH ST TRLR 72, FEDERAL WAY, WA 98003-7936
(206) 915-7393
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CG60140983
WA
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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