Provider Demographics
NPI:1003962309
Name:MARSCHALL, RICK
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:MARSCHALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:MARSCHALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:162 S BARR RD
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-9202
Mailing Address - Country:US
Mailing Address - Phone:360-457-1515
Mailing Address - Fax:360-452-7460
Practice Address - Street 1:162 S BARR RD
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-9202
Practice Address - Country:US
Practice Address - Phone:360-457-1515
Practice Address - Fax:360-452-7460
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000532175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA9555Medicare UPIN