Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 163531 | AK |
N | 2084N0402X | Child Neurologist | 163531 | AK |
NPI | 1083957070 |
---|---|
Provider Name | Dr. Cathleen E Marshall |
First Address | Portland, OR 97208-4105 |
Second Address | Anchorage, AK 99508-4691 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 04/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
777714100 | (05) | MD |