Provider Demographics
NPI:1427362094
Name:ANDREW MARRONE PROFESSIONAL SERVICES, P.S.
Entity Type:Organization
Organization Name:ANDREW MARRONE PROFESSIONAL SERVICES, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:MARRONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-367-8804
Mailing Address - Street 1:5709 137TH PL SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-9473
Mailing Address - Country:US
Mailing Address - Phone:425-609-4443
Mailing Address - Fax:425-609-4443
Practice Address - Street 1:5709 137TH PL SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-9473
Practice Address - Country:US
Practice Address - Phone:425-609-4443
Practice Address - Fax:425-609-4443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60014629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty