Healthcare Provider Details

I. General information

NPI: 1619955317
Provider Name (Legal Business Name): MARLI W PAROBEK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13401 VASHON HWY SW
VASHON WA
98070-3305
US

IV. Provider business mailing address

8511 KAIL DR
YAKIMA WA
98908-1039
US

V. Phone/Fax

Practice location:
  • Phone: 509-834-9714
  • Fax: 949-561-4854
Mailing address:
  • Phone: 509-834-9714
  • Fax: 949-561-4854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30007420
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP30007420
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: