Provider Demographics
NPI:1396251310
Name:WHALEN, MARLA DEE
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:DEE
Last Name:WHALEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARLA
Other - Middle Name:DEE
Other - Last Name:SOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDP
Mailing Address - Street 1:3033 INGRAM ST
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550-4410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3033 INGRAM ST
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550-4410
Practice Address - Country:US
Practice Address - Phone:360-999-7429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator