Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP60930121 | WA |
NPI | 1023575172 |
---|---|
Provider Name | Amber Elexis Marsh |
First Address | Richland, WA 99352-9532 |
Second Address | Richland, WA 99352-3300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2019 |
Last Update Date | 01/03/2021 |