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Individual

MS. AUDREY E. MARSHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
2411 PACIFIC AVE SE FL 1, OLYMPIA, WA 98501-2048
(360) 485-2237
(815) 301-3767
Mailing address
2411 PACIFIC AVE SE FL 1, OLYMPIA, WA 98501-2048
(360) 485-2237
(815) 301-3767

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA#12952
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
132940
L&I NUMBER
WA
01
8381MA
REGENCE BLUE SHIELD
WA
01
8382MA
REGENCE BLUE SHIELD
WA
Enumeration date
12/04/2006
Last updated
12/16/2013
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