=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295617520
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARLEIGH S NOSKA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2025
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2500 CHERRY AVE
-----------------------------------------------------
City | BREMERTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98310-4202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-620-3847
-----------------------------------------------------
Fax | 360-478-6993
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5102 13TH AVE S
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98108-2308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-371-2270
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | ARNP.AP.70020514-NP
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Registered Nurse
-----------------------------------------------------
License Number | RN.RN.60323992
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------