Individual
MS. MARLES BLACKBIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1001 EASTSIDE ST SE, SUITE C, OLYMPIA, WA 98501-1608
(360) 705-9758
(360) 705-9758
Mailing address
1125 12TH AVE SE, B-301, OLYMPIA, WA 98501-2415
(360) 705-9758
(360) 943-8018
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00007831
WA
Other
Enumeration date
05/04/2007
Last updated
10/19/2015
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