Healthcare Provider Details

I. General information

NPI: 1104722925
Provider Name (Legal Business Name): CHRISTINA OCTAVIA MARTIN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2026
Last Update Date: 10/19/2026
Certification Date: 10/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37TH AND O STREETS NW
WASHINGTON DC
20057-0001
US

IV. Provider business mailing address

37TH AND O STREETS NW
WASHINGTON DC
20057-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-687-0100
  • Fax: 202-979-3972
Mailing address:
  • Phone: 202-687-0100
  • Fax: 202-979-3972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: