Healthcare Provider Details

I. General information

NPI: 1497566590
Provider Name (Legal Business Name): TERRI L MARTINSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8502 N NEVADA ST STE 2
SPOKANE WA
99208-7395
US

IV. Provider business mailing address

26319 N DALTON RD
DEER PARK WA
99006-9721
US

V. Phone/Fax

Practice location:
  • Phone: 509-464-4970
  • Fax:
Mailing address:
  • Phone: 509-710-0743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN60527333
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: