| Doctor Name: | DR. MARC DAVID REDMON |
| NPI Number: | 1194756288 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PY00003507 |
| Business Practice Address: | 207 Avenue D Suite 100 Snohomish, WA - 982902773 |
| Business Phone Number: | 2063806142 |
| Business Fax Number: | 3602177729 |
| Mailing Address: | 207 Avenue D, Suite 100 SNOHOMISH |
| State: | WA |
| Postal Code: | 982902773 |
| Phone Number: | 2063806142 |
| Fax Number: | 3602177729 |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 05/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY00003507 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |