Provider Demographics
NPI:1730465998
Name:TOFSRUD, MARLA (NCACI, CCDCI, CDP)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:TOFSRUD
Suffix:
Gender:F
Credentials:NCACI, CCDCI, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E AUGUSTA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2481
Mailing Address - Country:US
Mailing Address - Phone:509-325-0777
Mailing Address - Fax:509-325-3464
Practice Address - Street 1:124 E AUGUSTA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2481
Practice Address - Country:US
Practice Address - Phone:509-325-0777
Practice Address - Fax:509-325-3464
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)