Provider Demographics
NPI:1548943640
Name:SABIN, MARISSA L
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:L
Last Name:SABIN
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 1:900 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:WA
Mailing Address - Zip Code:98356-9758
Mailing Address - Country:US
Mailing Address - Phone:785-375-9643
Mailing Address - Fax:
Practice Address - Street 1:900 MAIN AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:WA
Practice Address - Zip Code:98356-9758
Practice Address - Country:US
Practice Address - Phone:785-375-9643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide