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General NPI Number Information
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NPI Number | 1578282224
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Entity Type | Individual
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Provider Name | KAITLYN CHRISTINE MARTIN BA
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Gender | Female
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 2002 156TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98007-3827
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Country | US
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Telephone | 800-682-6934
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Fax |
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Provider Business Mailing Address
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Address Line | 22433 NE MARKETPLACE DR APT J2066
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City | REDMOND
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State | WA
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Zip | 98053-1922
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Country | US
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Telephone | 623-313-8005
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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