Provider Demographics
NPI:1912003575
Name:MARSHALL, LINDA MAHRIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MAHRIE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:MAHRIE
Other - Last Name:BROWNLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1740 NE DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-1217
Mailing Address - Country:US
Mailing Address - Phone:360-695-1115
Mailing Address - Fax:360-859-4689
Practice Address - Street 1:4001 MAIN ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-1887
Practice Address - Country:US
Practice Address - Phone:360-695-1115
Practice Address - Fax:360-859-4689
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000047771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical