Provider Demographics
NPI:1588361018
Name:MARSHALL, FLOYD LEIGHTON (MA)
Entity type:Individual
Prefix:
First Name:FLOYD
Middle Name:LEIGHTON
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8506 237TH ST E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-5737
Mailing Address - Country:US
Mailing Address - Phone:253-365-8944
Mailing Address - Fax:
Practice Address - Street 1:5900 100TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2749
Practice Address - Country:US
Practice Address - Phone:253-625-5942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL60919791101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor