P Laurine Marcinkowski, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY00002434 Issued in WA

Practice address

92ND Medical Group
200 N. Chennault Ste 100
Fairchild AFB, WA 99011

Phone

(509) 247-2731

Fax

(509) 247-4499

NPI assigned

Nov 22, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Department of Social Dept of SHS Div of Instns

  dba Eastern State Hospital

  • Psychiatric Hospital
  • Medical Lake, WA
  • NPI 1467440602
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538142732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92ND MEDICAL GROUP",
            "address_2": "200 N. CHENNAULT STE 100",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "99011",
            "telephone_number": "509-247-2731",
            "fax_number": "509-247-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92ND MEDICAL GROUP",
            "address_2": "200 N. CHENNAULT STE 100",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "99011",
            "telephone_number": "509-247-2731",
            "fax_number": "509-247-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINKOWSKI",
        "first_name": "P",
        "middle_name": "LAURINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00002434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie L Lucas
• Mark Lussier, M.D.
• Alyssa Mann
• Noah Manubay, DDS
• Benjamin Joseph Marcheschi, DO
• Kelly Massey, LSWAIC
• Emily Rose Masters
• Leslie Mathis, PT, DPT
• Jeremy Isak Matis, DDS
• Collin Douglas Mayer

• Psychologist in Fairchild AFB, WA
• Providers in Fairchild AFB, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.