Healthcare Provider Details

I. General information

NPI: 1538783154
Provider Name (Legal Business Name): LIVINGSTON PFALZGRAF MARTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 MADISON AVE N STE 200
BAINBRIDGE ISLAND WA
98110-1890
US

IV. Provider business mailing address

360 ASHBURY CT NW
BAINBRIDGE ISLAND WA
98110-5160
US

V. Phone/Fax

Practice location:
  • Phone: 206-528-8000
  • Fax: 206-880-7890
Mailing address:
  • Phone: 971-678-0344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License NumberMD61321643
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD61321643
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: