Provider Demographics
NPI:1366269896
Name:MAAHS, NICHOLE DANIELLE
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:DANIELLE
Last Name:MAAHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 NE MCCALLISTER LN
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-7709
Mailing Address - Country:US
Mailing Address - Phone:541-561-0426
Mailing Address - Fax:
Practice Address - Street 1:920 SW FRAZER AVE STE 102
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2800
Practice Address - Country:US
Practice Address - Phone:971-308-4587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program