Provider Demographics
NPI:1528422250
Name:MARX, LAURA MARIE (PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:MARX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PROVIDENCE MEDICAL GROUP PHYSICAL THERAPY
Mailing Address - Street 2:4730 COLBY AVE, SUITE 220
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2927
Mailing Address - Country:US
Mailing Address - Phone:425-297-6888
Mailing Address - Fax:425-294-6889
Practice Address - Street 1:PROVIDENCE MEDICAL GROUP PHYSICAL THERAPY
Practice Address - Street 2:4730 COLBY AVE, SUITE 220
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2927
Practice Address - Country:US
Practice Address - Phone:425-297-6888
Practice Address - Fax:425-294-6889
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60712270225100000X
OH014730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist