Provider Demographics
NPI:1063532943
Name:KREMEN, MARILYN M (MC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:M
Last Name:KREMEN
Suffix:
Gender:F
Credentials:MC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1687 114TH AVE SE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6964
Mailing Address - Country:US
Mailing Address - Phone:425-454-8171
Mailing Address - Fax:425-455-0848
Practice Address - Street 1:1687 114TH AVE SE
Practice Address - Street 2:SUITE 125
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6964
Practice Address - Country:US
Practice Address - Phone:425-454-8171
Practice Address - Fax:425-455-0848
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004170101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health