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General NPI Number Information
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NPI Number | 1952568958
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Entity Type | Individual
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Provider Name | MARCI DAWN THYREN LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 9040-A FITZSIMMONS DR
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-2303
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Fax |
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Provider Business Mailing Address
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Address Line | 18208 72ND AVE E
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City | PUYALLUP
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State | WA
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Zip | 98375-1849
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Country | US
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Telephone | 360-865-0239
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1055
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License Number State | CO
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