Provider Demographics
NPI:1669512315
Name:WRIGHT, MARMAR MAZHARI (DC)
Entity type:Individual
Prefix:DR
First Name:MARMAR
Middle Name:MAZHARI
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MARMAR
Other - Middle Name:M
Other - Last Name:MAZHARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4479 249TH TER SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-5811
Mailing Address - Country:US
Mailing Address - Phone:425-677-7227
Mailing Address - Fax:
Practice Address - Street 1:1299 156TH AVE NE STE 123
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-7562
Practice Address - Country:US
Practice Address - Phone:425-641-8481
Practice Address - Fax:425-641-0880
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034512111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACH00034512OtherCHIROPRACTIC LICENSE