Provider Demographics
NPI:1477627123
Name:MARSDEN, JUDITH L (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:L
Last Name:MARSDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JUDITH
Other - Middle Name:L
Other - Last Name:MARSDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:15209 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1114
Mailing Address - Country:US
Mailing Address - Phone:206-242-7337
Mailing Address - Fax:206-988-0865
Practice Address - Street 1:15209 8TH AVE S
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1114
Practice Address - Country:US
Practice Address - Phone:206-242-7337
Practice Address - Fax:206-988-0865
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADSHS1541507Medicaid
WAA05099Medicare UPIN