Provider Demographics
NPI:1831509678
Name:MARKER-PETRILLI, MARCILE (LM, CPM)
Entity type:Individual
Prefix:
First Name:MARCILE
Middle Name:
Last Name:MARKER-PETRILLI
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20315 S CLODFELTER RD
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-9425
Mailing Address - Country:US
Mailing Address - Phone:509-496-9330
Mailing Address - Fax:509-627-3674
Practice Address - Street 1:20315 S CLODFELTER RD
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-9425
Practice Address - Country:US
Practice Address - Phone:509-496-9330
Practice Address - Fax:509-672-3674
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603547784176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife