Provider Demographics
NPI:1881833242
Name:MARION, ALISHA SHIREEN (LMP)
Entity Type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:SHIREEN
Last Name:MARION
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 N BAKER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-3107
Mailing Address - Country:US
Mailing Address - Phone:360-420-0823
Mailing Address - Fax:
Practice Address - Street 1:9328 271ST ST NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-8072
Practice Address - Country:US
Practice Address - Phone:360-420-0823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022273174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist