Healthcare Provider Details

I. General information

NPI: 1073759486
Provider Name (Legal Business Name): MARLES JEAN GEIST RN, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BISHOP RD
CHEHALIS WA
98532-8711
US

IV. Provider business mailing address

1201 BISHOP RD
CHEHALIS WA
98532-8711
US

V. Phone/Fax

Practice location:
  • Phone: 360-345-1381
  • Fax: 360-345-1382
Mailing address:
  • Phone: 360-345-1381
  • Fax: 360-345-1382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30002101
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: