Provider Demographics
NPI:1174874937
Name:VEACH, MARLA ROCHELLE
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:ROCHELLE
Last Name:VEACH
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 1:327 81ST DR SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-3188
Mailing Address - Country:US
Mailing Address - Phone:425-397-6298
Mailing Address - Fax:
Practice Address - Street 1:2613 W MARINE VIEW DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3420
Practice Address - Country:US
Practice Address - Phone:425-349-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60301640101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health