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Individual

MRS. TERESA ANN MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
10004 204TH AVE E, #3400, BONNEY LAKE, WA 98391-6539
(253) 848-5951
(253) 845-7073
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 845-7073

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60009330
WA
363LF0000X
Family Nurse Practitioner
AP60009330
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9656869
WA
Enumeration date
03/22/2008
Last updated
12/06/2016
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