Healthcare Provider Details

I. General information

NPI: 1821171935
Provider Name (Legal Business Name): PATRICIA A MARTIN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 116TH AVE NE SUITE 101
BELLEVUE WA
98004-3034
US

IV. Provider business mailing address

PO BOX 13684
SEATTLE WA
98198-1010
US

V. Phone/Fax

Practice location:
  • Phone: 206-592-5000
  • Fax: 206-824-9510
Mailing address:
  • Phone: 206-592-5000
  • Fax: 206-824-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA A MARTIN
Title or Position: OWNER
Credential: MD
Phone: 425-865-9310