Individual
DR. LEA MARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
167 1ST AVE N, PO BOX N, ILWACO, WA 98624-9137
(360) 642-6498
(360) 642-0114
Mailing address
PO BOX N, ILWACO, WA 98624-9137
(360) 642-6498
(360) 642-0114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
063370
GA
207Q00000X
Family Medicine Physician
MD60202294
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
314276978A
—
GA
05
—
GA1010
—
SC
Enumeration date
04/20/2006
Last updated
07/14/2011
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