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General NPI Number Information
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NPI Number | 1386569317
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Entity Type | Individual
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Provider Name | ANDREE MARIE MARCUS-RADER LSWAIC
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 727 S GRAND AVE
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City | PULLMAN
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State | WA
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Zip | 99163-2136
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Country | US
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Telephone | 208-882-2566
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 134
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City | PALOUSE
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State | WA
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Zip | 99161-0134
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Country | US
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Telephone | 509-592-5712
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2081517
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWIA.SC.70149988
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License Number State | WA
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