Healthcare Provider Details

I. General information

NPI: 1477604759
Provider Name (Legal Business Name): CHRISTINA M MARSH RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 16TH AVE E
SEATTLE WA
98112-5211
US

IV. Provider business mailing address

1100 9TH AVE M4-PFS
SEATTLE WA
98101-2756
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-3000
  • Fax: 877-515-2975
Mailing address:
  • Phone: 206-583-6025
  • Fax: 206-515-5886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3071462
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI00001443
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: