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General NPI Number Information
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NPI Number | 1952408205
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Entity Type | Individual
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Provider Name | GARY MARTIN MARTZ D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 1660 SOUTH COLUMBIAN WAY
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City | SEATTLE
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State | WA
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Zip | 98108-1597
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Country | US
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Telephone | 253-583-1172
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Fax | 206-764-2187
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Provider Business Mailing Address
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Address Line | 1660 S COLUMBIAN WAY
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City | SEATTLE
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State | WA
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Zip | 98108-1532
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Country | US
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Telephone | 253-583-1172
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS005995L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11139
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0102050068
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OP60068825
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OP60069825
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License Number State | WA
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