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Individual

TERRISA R MUSTARD-MARSHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
4323 RUCKER AVE, A, EVERETT, WA 98203-2213
(425) 314-4842
(425) 339-2221
Mailing address
10110 19TH AVE SE, E-102, EVERETT, WA 98208-4249
(425) 314-4842
(425) 339-2221

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00024827
WA

Other

Enumeration date
03/07/2008
Last updated
03/07/2008
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