MEDICARE: JANILE MARTIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	30004936	WA

General Provider Information

NPI Number	:	1326099482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANILE MARTIN

Provider Business Mailing Address
First Line	:	1601 116TH AVE NE
Second Line	:	SUITE 100
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3010
Country	:	US
Telephone Number	:	425-451-0999
Fax Number	:	425-451-7399

Provider Business Practice Location Address
First Line	:	1601 116TH AVE NE
Second Line	:	SUITE 100
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3010
Country	:	US
Telephone Number	:	425-451-0999
Fax Number	:	425-451-7399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	12/09/2011

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Directions to “ JANILE MARTIN ” Practice Location

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