Provider Demographics
NPI:1497255863
Name:BENTLEY, MARINAH
Entity type:Individual
Prefix:
First Name:MARINAH
Middle Name:
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35703 16TH AVE S APT H102
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7387
Mailing Address - Country:US
Mailing Address - Phone:250-202-6232
Mailing Address - Fax:
Practice Address - Street 1:35703 16TH AVE S APT H102
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7387
Practice Address - Country:US
Practice Address - Phone:253-202-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor