Healthcare Provider Details

I. General information

NPI: 1023773413
Provider Name (Legal Business Name): MARISSA THIRION
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 9TH AVE NE STE 300
SEATTLE WA
98105-4762
US

IV. Provider business mailing address

1532 24TH AVE APT B
SEATTLE WA
98122-3199
US

V. Phone/Fax

Practice location:
  • Phone: 206-608-8251
  • Fax:
Mailing address:
  • Phone: 330-998-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: