Provider Demographics
NPI:1457168783
Name:MORTON, MARISSA (HIS)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21727 76TH AVE W STE A
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7549
Mailing Address - Country:US
Mailing Address - Phone:425-286-8178
Mailing Address - Fax:
Practice Address - Street 1:21727 76TH AVE W STE A
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7549
Practice Address - Country:US
Practice Address - Phone:425-286-8178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist