Provider Demographics
NPI:1891721023
Name:MARSKE, CYNTHIA SUE (DO)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SUE
Last Name:MARSKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:SUE
Other - Last Name:SHARPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:530 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-5223
Mailing Address - Country:US
Mailing Address - Phone:541-766-6835
Mailing Address - Fax:541-766-6186
Practice Address - Street 1:530 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330
Practice Address - Country:US
Practice Address - Phone:541-766-6835
Practice Address - Fax:541-766-6186
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8560207R00000X
ORDO150418207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500616008Medicaid
ORR164954OtherMEDICARE TPIN
CAH31359Medicare UPIN