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General NPI Number Information
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NPI Number | 1083652846
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Entity Type | Individual
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Provider Name | DAVID B MARTIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 1625 5TH ST
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City | CLARKSTON
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State | WA
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Zip | 99403
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Country | US
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Telephone | 509-751-9981
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Fax | 509-751-9983
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Provider Business Mailing Address
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Address Line | 1625 5TH ST
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City | CLARKSTON
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State | WA
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Zip | 99403-3001
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Country | US
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Telephone | 509-751-9981
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Fax | 509-751-9983
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00033883
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G45192
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M7091
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License Number State | ID
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