MEDICARE: KATE MARTIS PA-C

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	363A00000X	Physician Assistant	PA.60182624	WA
2	363A00000X	Physician Assistant	0010-03315	NC
3	363AM0700X	Medical Physician Assistant	PA031060	DC

General Provider Information

NPI Number	:	1972804243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE MARTIS PA-C

Provider Business Mailing Address
First Line	:	1627 EYE ST NW
Second Line	:	SUITE 800
City	:	WASHINGTON
State	:	DC
Zip	:	20006-4007
Country	:	US
Telephone Number	:	202-660-0025
Fax Number	:	202-660-0015

Provider Business Practice Location Address
First Line	:	1627 EYE ST NW
Second Line	:	SUITE 800
City	:	WASHINGTON
State	:	DC
Zip	:	20006-4007
Country	:	US
Telephone Number	:	202-660-0025
Fax Number	:	202-660-0015

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

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	07/29/2014

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Directions to “ KATE MARTIS PA-C” Practice Location

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