Healthcare Provider Details

I. General information

NPI: 1225167224
Provider Name (Legal Business Name): MARLAYNA ANN SOENNEKER M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 NE OAK VIEW DR STE B
VANCOUVER WA
98662-6347
US

IV. Provider business mailing address

2323 NW 188TH AVE APT 716
HILLSBORO OR
97124-7063
US

V. Phone/Fax

Practice location:
  • Phone: 260-213-2419
  • Fax: 503-567-2212
Mailing address:
  • Phone: 503-617-1766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: