Basic Information
Provider Information
NPI: 1770029803
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: MARINDA
MiddleName:  
NamePrefix:  
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Credential: PT, DPT
OtherOrganizationName:  
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Mailing Information
Address1: 8750 GREENWOOD AVE N
Address2: S-1
City: SEATTLE
State: WA
PostalCode: 98103
CountryCode: US
TelephoneNumber: 2067825789
FaxNumber: 2067825794
Practice Location
Address1: 3290 NE 65TH STREET
Address2: UNIT 101
City: SEATTLE
State: WA
PostalCode: 98115
CountryCode: US
TelephoneNumber: 2063882549
FaxNumber: 2068294352
Other Information
ProviderEnumerationDate: 01/12/2017
LastUpdateDate: 11/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X0014259CON Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X60682298WAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT60682298WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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