Provider Demographics
NPI:1922346972
Name:MARSHALL, LORI
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NE HEARTHWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-7407
Mailing Address - Country:US
Mailing Address - Phone:360-604-6875
Mailing Address - Fax:360-604-6877
Practice Address - Street 1:801 NE HEARTHWOOD BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-7407
Practice Address - Country:US
Practice Address - Phone:360-604-6875
Practice Address - Fax:360-604-6877
Is Sole Proprietor?:No
Enumeration Date:2013-01-26
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA421705E235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist