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Organization

PROVIDENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KRISTAL CORRINE MARSON OTR/L (OTR/L)
(360) 386-8061
Entity
Organization

Contact information

Practice address
5019 126TH ST NE, MARYSVILLE, WA 98271-9062
(360) 386-8061
Mailing address
5019 126TH ST. NE, MARYSVILLE, WA 98271
(360) 386-8061

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
OT00004622
WA

Other

Enumeration date
09/19/2008
Last updated
09/19/2008
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