Provider Demographics
NPI:1548152317
Name:MARSHALL, PATRICK ALEXANDER (PARAPROFESSIONAL)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:ALEXANDER
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:PARAPROFESSIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 E SELTICE WAY
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7007
Mailing Address - Country:US
Mailing Address - Phone:208-661-9453
Mailing Address - Fax:
Practice Address - Street 1:1616 E SELTICE WAY
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7007
Practice Address - Country:US
Practice Address - Phone:208-661-9453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach