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General NPI Number Information
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NPI Number | 1124223656
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Entity Type | Individual
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Provider Name | ALICIA RODRIGUEZ MARROQUIN R.N., MA, CNS, PHD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 1216 WINSOR AVE
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City | NORTH BEND
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State | OR
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Zip | 97459-3643
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Country | US
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Telephone | 360-473-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 WINSOR AVE
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City | NORTH BEND
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State | OR
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Zip | 97459-3643
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Country | US
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Telephone | 360-473-7777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 167681
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN00069310
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 200943348RN
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License Number State | OR
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