# PROVIDENCE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821248402
- **Authorized official:** MRS. KRISTAL CORRINE MARSON OTR/L (OTR/L)
- **Authorized official phone:** (360) 386-8061

## Contact information

- **Practice address:** 5019 126TH ST NE, MARYSVILLE, WA 98271-9062
- **Practice address phone:** (360) 386-8061
- **Mailing address:** 5019 126TH ST. NE, MARYSVILLE, WA 98271
- **Mailing address phone:** (360) 386-8061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | OT00004622 | WA | Yes |

## Other

- **Enumeration date:** 09/19/2008
- **Last updated:** 09/19/2008