1912003575 NPI number — MS. LINDA MAHRIE MARSHALL M.S.W.

Table of content: MS. LINDA MAHRIE MARSHALL M.S.W. (NPI 1912003575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912003575 NPI number — MS. LINDA MAHRIE MARSHALL M.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARSHALL
Provider First Name:
LINDA
Provider Middle Name:
MAHRIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWNLEE
Provider Other First Name:
LINDA
Provider Other Middle Name:
MAHRIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912003575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1740 NE DALLAS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMAS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98607-1217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-695-1115
Provider Business Mailing Address Fax Number:
360-859-4689

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4001 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98663-1887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-695-1115
Provider Business Practice Location Address Fax Number:
360-859-4689
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LW00004777 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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