Healthcare Provider Details

I. General information

NPI: 1336442334
Provider Name (Legal Business Name): MARLENE HILLYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARLENE MALTBY

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 8TH ST STE 110
VANCOUVER WA
98660-3294
US

IV. Provider business mailing address

8301B 5TH AVE NE
SEATTLE WA
98115-4118
US

V. Phone/Fax

Practice location:
  • Phone: 360-209-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI60202010
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: