Individual
JAKE ALAN MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1750 112TH AVE NE, SUITE D-154, BELLEVUE, WA 98004-3752
(661) 373-7851
Mailing address
1750 112TH AVE NE, SUITE D-154, BELLEVUE, WA 98004-3752
(661) 373-7851
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A1 60327189
WA
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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