Provider Demographics
NPI:1285645390
Name:WHITMARSH, MARELDA M (ARPN, MN, RN NP-C)
Entity Type:Individual
Prefix:
First Name:MARELDA
Middle Name:M
Last Name:WHITMARSH
Suffix:
Gender:F
Credentials:ARPN, MN, RN NP-C
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-0340
Mailing Address - Country:US
Mailing Address - Phone:509-262-9000
Mailing Address - Fax:509-276-3034
Practice Address - Street 1:5952 BLACKSTONE WAY
Practice Address - Street 2:
Practice Address - City:NINE MILE FALLS
Practice Address - State:WA
Practice Address - Zip Code:99026-4900
Practice Address - Country:US
Practice Address - Phone:509-464-3627
Practice Address - Fax:509-466-9517
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2022-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZAP4151363LF0000X
WAAP30006598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily