Provider Demographics
NPI:1629886080
Name:HARFORD, MARISSA SHAYLENE (CPC)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:SHAYLENE
Last Name:HARFORD
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CHERRY ST SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1433
Mailing Address - Country:US
Mailing Address - Phone:360-338-3744
Mailing Address - Fax:
Practice Address - Street 1:1000 CHERRY ST SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1433
Practice Address - Country:US
Practice Address - Phone:360-338-3744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor