Provider Demographics
NPI:1629105614
Name:MORGENSEN, MARICEL L (NCLMT)
Entity Type:Individual
Prefix:MRS
First Name:MARICEL
Middle Name:L
Last Name:MORGENSEN
Suffix:
Gender:F
Credentials:NCLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6222 28TH ST NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-3317
Mailing Address - Country:US
Mailing Address - Phone:253-946-2000
Mailing Address - Fax:
Practice Address - Street 1:1305 S 312TH
Practice Address - Street 2:SUITE 202
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-9028
Practice Address - Country:US
Practice Address - Phone:253-946-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019864175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath