Provider Demographics
NPI:1841152857
Name:MARYANNE GODFREY ARNP MN LLC
Entity type:Organization
Organization Name:MARYANNE GODFREY ARNP MN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP MN
Authorized Official - Phone:360-305-7376
Mailing Address - Street 1:1728 W MARINE VIEW DR STE 109
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2094
Mailing Address - Country:US
Mailing Address - Phone:425-252-9216
Mailing Address - Fax:425-252-8637
Practice Address - Street 1:1728 W MARINE VIEW DR STE 109
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2094
Practice Address - Country:US
Practice Address - Phone:425-252-9216
Practice Address - Fax:425-252-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-27
Last Update Date:2025-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty