Provider Demographics
NPI:1285681668
Name:MARSTON-QUIVEY, NANCY ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ELLEN
Last Name:MARSTON-QUIVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ELLEN
Other - Last Name:MANNWEILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:638 SILVER CREEK PLACE
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-8840
Mailing Address - Country:US
Mailing Address - Phone:360-724-0459
Mailing Address - Fax:
Practice Address - Street 1:330 SOUTH STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:509-837-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044297207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C47350Medicare UPIN