Provider Demographics
NPI:1023119088
Name:MITCHELL, MARINA C (RN)
Entity type:Individual
Prefix:MS
First Name:MARINA
Middle Name:C
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MARINA
Other - Middle Name:C
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12223 NE 97TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5819
Mailing Address - Country:US
Mailing Address - Phone:425-827-5321
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-764-2012
Practice Address - Fax:206-764-2153
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00090174163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis