Provider Demographics
NPI:1477084317
Name:CEYA, MARIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:CEYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32650 STATE ROUTE 20
Mailing Address - Street 2:SUITE E203
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-2641
Mailing Address - Country:US
Mailing Address - Phone:360-682-6499
Mailing Address - Fax:
Practice Address - Street 1:32650 STATE ROUTE 20
Practice Address - Street 2:SUITE E203
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-2641
Practice Address - Country:US
Practice Address - Phone:360-682-6499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health