Individual
CAROLLY R. MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2499
(206) 744-3000
Mailing address
325 9TH AVE, BOX 359930, SEATTLE, WA 98104-2499
(206) 744-5100
(206) 744-5109
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30003220
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30003220
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0155093
L&I PIN
WA
01
—
53381U
REGENCE BLUE SHIELD PIN
WA
05
—
9610908
—
WA
Enumeration date
07/04/2006
Last updated
06/27/2011
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