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General NPI Number Information
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NPI Number | 1831105766
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Entity Type | Individual
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Provider Name | PAUL J MARANO PHD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 09/03/2012
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Provider Practice Location Address
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Address Line | 175 PARFITT WAY SW SUITE N260
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-2584
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Country | US
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Telephone | 206-755-0971
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Fax |
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Provider Business Mailing Address
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Address Line | 175 PARFITT WAY SW SUITE N260
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-2584
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Country | US
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Telephone | 206-755-0971
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1526
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License Number State | WA
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