Provider Demographics
NPI:1316295751
Name:STUJ, MARZENA (LMP)
Entity type:Individual
Prefix:MRS
First Name:MARZENA
Middle Name:
Last Name:STUJ
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13433 NE 20TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2024
Mailing Address - Country:US
Mailing Address - Phone:425-747-7785
Mailing Address - Fax:425-747-7716
Practice Address - Street 1:13433 NE 20TH ST
Practice Address - Street 2:STE D
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2024
Practice Address - Country:US
Practice Address - Phone:425-747-7785
Practice Address - Fax:425-747-7716
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60117878174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist