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General NPI Number Information
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NPI Number | 1578601472
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Entity Type | Individual
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Provider Name | KRYSTEL E MARTIN PHARM D
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Gender | Female
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10452 SILVERDALE WAY NW
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City | SILVERDALE
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State | WA
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Zip | 98383-9411
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Country | US
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Telephone | 360-307-7422
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 954
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City | SILVERDALE
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State | WA
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Zip | 98383-0954
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Country | US
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Telephone | 360-373-1788
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00021550
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License Number State | WA
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