1821171935 NPI number — PATRICIA A MARTIN MD PLLC

Table of content: (NPI 1821171935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821171935 NPI number — PATRICIA A MARTIN MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATRICIA A MARTIN MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821171935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13684
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98198-1010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-592-5000
Provider Business Mailing Address Fax Number:
206-824-9510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1605 116TH AVE NE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-3034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-592-5000
Provider Business Practice Location Address Fax Number:
206-824-9510
Provider Enumeration Date:
10/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
425-865-9310

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DF9365 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com