Provider Demographics
NPI:1578829693
Name:MEYERS, MARSHA MARIE (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:MARIE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:MARSHA
Other - Middle Name:MARIE
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 114TH AVE SE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6950
Mailing Address - Country:US
Mailing Address - Phone:425-462-7909
Mailing Address - Fax:425-643-8903
Practice Address - Street 1:1601 114TH AVE SE
Practice Address - Street 2:SUITE 108
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6950
Practice Address - Country:US
Practice Address - Phone:425-462-7909
Practice Address - Fax:425-643-8903
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASW000044911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical