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Individual
MARTHA C PAO
Active
Individual
MARTHA C PAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004551
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0175422
LIWA
WA
01
—
2414PA
BSWA
WA
05
—
8364077
—
WA
Enumeration date
06/17/2006
Last updated
09/27/2024
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