Provider Demographics
NPI:1003869132
Name:NORDEN, MARIANNE HEVLY (OTR)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:HEVLY
Last Name:NORDEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:HEVLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 7235
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98417-0235
Mailing Address - Country:US
Mailing Address - Phone:253-579-6339
Mailing Address - Fax:253-465-3112
Practice Address - Street 1:309 S G ST STE 4
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4758
Practice Address - Country:US
Practice Address - Phone:253-465-3111
Practice Address - Fax:253-465-3112
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001604225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand