Provider Demographics
NPI:1386811214
Name:WRIGHT, MARLAENA CHRISTINE (LMP)
Entity type:Individual
Prefix:MS
First Name:MARLAENA
Middle Name:CHRISTINE
Last Name:WRIGHT
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 1:106 W PINE ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-4204
Mailing Address - Country:US
Mailing Address - Phone:360-388-0551
Mailing Address - Fax:
Practice Address - Street 1:106 W PINE ST
Practice Address - Street 2:SUITE 8
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-4204
Practice Address - Country:US
Practice Address - Phone:360-388-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA14265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist