Provider Demographics
NPI:1649732793
Name:VALENZUELA, MARSHA ROSE (CG60600683)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:ROSE
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:CG60600683
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 W. BROADWAY AVE.
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201
Mailing Address - Country:US
Mailing Address - Phone:509-473-4811
Mailing Address - Fax:509-473-4840
Practice Address - Street 1:PARTNERS WITH FAMILIES AND CHILDREN
Practice Address - Street 2:1321 W. BROADWAY
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201
Practice Address - Country:US
Practice Address - Phone:509-473-4811
Practice Address - Fax:509-473-4840
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist