Provider Demographics
NPI:1265641005
Name:HOUCK, MARJIE ANN (RN, LDM)
Entity type:Individual
Prefix:MS
First Name:MARJIE
Middle Name:ANN
Last Name:HOUCK
Suffix:
Gender:F
Credentials:RN, LDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28631 SUTHERLIN LN
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405
Mailing Address - Country:US
Mailing Address - Phone:541-517-0839
Mailing Address - Fax:541-683-7389
Practice Address - Street 1:28631 SUTHERLIN LN
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-517-0839
Practice Address - Fax:541-683-7389
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-573933176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife