Provider Demographics
NPI:1205108354
Name:KARTCHNER, MARIANNE F
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:F
Last Name:KARTCHNER
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 1:1215 N MCDONALD RD
Mailing Address - Street 2:STE 101
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1557
Mailing Address - Country:US
Mailing Address - Phone:509-924-1950
Mailing Address - Fax:
Practice Address - Street 1:6814 S JACKSON RIDGE LN
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:WA
Practice Address - Zip Code:99016-8725
Practice Address - Country:US
Practice Address - Phone:509-927-0359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60295868363L00000X
WARN00158537390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner