Provider Demographics
NPI:1518386267
Name:CALVERT, MARLA LOUISE (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:LOUISE
Last Name:CALVERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MARLA
Other - Middle Name:LOUISE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1316
Mailing Address - Country:US
Mailing Address - Phone:206-386-6054
Mailing Address - Fax:206-215-6027
Practice Address - Street 1:700 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5115
Practice Address - Country:US
Practice Address - Phone:360-923-7000
Practice Address - Fax:360-923-7089
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60662881207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine