Healthcare Provider Details

I. General information

NPI: 1083808182
Provider Name (Legal Business Name): MARSHALL JONATHON SAIPHER ANP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2641 ARROWROOT LOOP SE
LACEY WA
98513-4005
US

IV. Provider business mailing address

2641 ARROWROOT LOOP SE
LACEY WA
98513-4005
US

V. Phone/Fax

Practice location:
  • Phone: 214-238-5036
  • Fax:
Mailing address:
  • Phone: 214-238-5036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP.61309239-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: