Individual
MARISSA STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3050 PENNSYLVANIA ST, LONGVIEW, WA 98632-4326
(360) 957-9882
Mailing address
3050 PENNSYLVANIA ST, LONGVIEW, WA 98632-4326
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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