Healthcare Provider Details

I. General information

NPI: 1366192346
Provider Name (Legal Business Name): FREEMAN, MARTIN & MARTIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 SE 164TH AVE STE 118
VANCOUVER WA
98683-8602
US

IV. Provider business mailing address

1825 SE 164TH AVE STE 118
VANCOUVER WA
98683-8602
US

V. Phone/Fax

Practice location:
  • Phone: 360-524-7677
  • Fax: 360-326-1668
Mailing address:
  • Phone: 360-524-7677
  • Fax: 360-326-1668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MARTIN
Title or Position: CO-OWNER, LEAD DC
Credential: DC
Phone: 360-524-7677