Provider Demographics
NPI:1336945716
Name:STEVENS, MARYN CATHERINE (MA)
Entity type:Individual
Prefix:
First Name:MARYN
Middle Name:CATHERINE
Last Name:STEVENS
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 POLIHALE PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-2115
Mailing Address - Country:US
Mailing Address - Phone:808-208-7811
Mailing Address - Fax:
Practice Address - Street 1:307 N OLYMPIC AVE STE 234
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1322
Practice Address - Country:US
Practice Address - Phone:360-572-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health