Provider Demographics
NPI:1255414355
Name:MAHER, DONNA L (MS RD)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:L
Last Name:MAHER
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24528 147TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-3336
Mailing Address - Country:US
Mailing Address - Phone:425-235-7815
Mailing Address - Fax:425-235-7832
Practice Address - Street 1:24528 147TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-3336
Practice Address - Country:US
Practice Address - Phone:425-235-7815
Practice Address - Fax:425-235-7832
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA709191133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered