Provider Demographics
NPI:1285902866
Name:MARION, DEBRA GAIL (SPCP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:GAIL
Last Name:MARION
Suffix:
Gender:F
Credentials:SPCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 HARBORVIEW DR 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-2100
Mailing Address - Country:US
Mailing Address - Phone:253-509-0482
Mailing Address - Fax:253-857-4814
Practice Address - Street 1:3417 HARBORVIEW DR FL 3
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-2100
Practice Address - Country:US
Practice Address - Phone:253-509-0482
Practice Address - Fax:253-857-4814
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602336426174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist