Provider Demographics
NPI:1396859906
Name:STRAYER, MARILYNN A (MD)
Entity Type:Individual
Prefix:
First Name:MARILYNN
Middle Name:A
Last Name:STRAYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARILYNN
Other - Middle Name:WEIDNER
Other - Last Name:STRAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2520 GOSS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-9616
Mailing Address - Country:US
Mailing Address - Phone:360-331-7458
Mailing Address - Fax:
Practice Address - Street 1:105 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239
Practice Address - Country:US
Practice Address - Phone:360-678-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000382892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry