Healthcare Provider Details

I. General information

NPI: 1205934684
Provider Name (Legal Business Name): DARYLL G. MARSHALL-INMAN DC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17651 1ST AVE S #101
NORMANDY PARK WA
98148-2715
US

IV. Provider business mailing address

17651 1ST AVE S #101
NORMANDY PARK WA
98148-2715
US

V. Phone/Fax

Practice location:
  • Phone: 206-241-3836
  • Fax: 206-241-3967
Mailing address:
  • Phone: 206-241-3836
  • Fax: 206-241-3967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279P4000X
TaxonomyPatient Transport Registered Respiratory Therapist
License NumberMA00019960
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00003368
License Number StateWA

VIII. Authorized Official

Name: MRS. DARYL G MARSHALL-INMAN
Title or Position: OWNER
Credential: DC
Phone: 425-361-1839