Provider Demographics
NPI:1255379905
Name:TOMLINSON, MARSHA JANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:JANETTE
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:M.
Other - Middle Name:JANETTE
Other - Last Name:TOMLINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1415 E. KINCAID STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4126
Mailing Address - Country:US
Mailing Address - Phone:360-424-4111
Mailing Address - Fax:
Practice Address - Street 1:1415 E. KINCAID STREET
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4126
Practice Address - Country:US
Practice Address - Phone:360-424-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-091105207P00000X
WI45204-020207P00000X
WAMD60182971207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036091105Medicaid
IL930062807OtherMEDICARE RAILROAD
ILL63988Medicare ID - Type Unspecified
IL930062807OtherMEDICARE RAILROAD