Provider Demographics
NPI:1912089608
Name:MARSHALL, JODY ELAINE (AA, MHT3)
Entity Type:Individual
Prefix:MS
First Name:JODY
Middle Name:ELAINE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:AA, MHT3
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21307 13TH PL W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8623
Mailing Address - Country:US
Mailing Address - Phone:425-772-2837
Mailing Address - Fax:425-349-7288
Practice Address - Street 1:3322 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4425
Practice Address - Country:US
Practice Address - Phone:425-349-7289
Practice Address - Fax:425-349-7288
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor