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General NPI Number Information
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NPI Number | 1891509956
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Entity Type | Individual
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Provider Name | MARTHA JANE PEAD RBT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 12826 SE 40TH LN STE A10
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City | BELLEVUE
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State | WA
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Zip | 98006-5266
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Country | US
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Telephone | 206-409-6319
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Fax |
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Provider Business Mailing Address
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Address Line | 821 S WASHINGTON ST APT 322
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City | SEATTLE
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State | WA
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Zip | 98104-3332
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Country | US
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Telephone | 817-437-1720
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | RBT-20-119291
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License Number State | TX
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