Provider Demographics
NPI:1851166508
Name:SCRIBNER, MARISSA NICOLE (LAC, EAMP)
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:NICOLE
Last Name:SCRIBNER
Suffix:
Gender:F
Credentials:LAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 SW 175TH ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3353
Mailing Address - Country:US
Mailing Address - Phone:865-809-9877
Mailing Address - Fax:
Practice Address - Street 1:1630 SW 175TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3353
Practice Address - Country:US
Practice Address - Phone:865-809-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61408318171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist