Healthcare Provider Details

I. General information

NPI: 1619184827
Provider Name (Legal Business Name): NORMAN JAMES MAR PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MINOR AVE STE 230
SEATTLE WA
98104-2133
US

IV. Provider business mailing address

8141 6TH AVE SW
SEATTLE WA
98106-2152
US

V. Phone/Fax

Practice location:
  • Phone: 206-340-8009
  • Fax: 206-344-5234
Mailing address:
  • Phone: 206-762-6541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number2433
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: