Healthcare Provider Details

I. General information

NPI: 1316409006
Provider Name (Legal Business Name): CARTER MARTYN NEWEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S PIONEER WAY STE 220
MOSES LAKE WA
98837-4613
US

IV. Provider business mailing address

1616 S PIONEER WAY
MOSES LAKE WA
98837-2487
US

V. Phone/Fax

Practice location:
  • Phone: 509-793-9733
  • Fax: 509-764-3279
Mailing address:
  • Phone: 509-793-9715
  • Fax: 509-764-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOP61386915
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: