Individual
JENNIFER LEE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
Mailing address
PO BOX 751461, CHARLESTON, SC 29425-3230
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OT016512
PA
2085R0202X
Diagnostic Radiology Physician
100138
GA
2085R0202X
Diagnostic Radiology Physician
39092
SC
2085R0202X
Diagnostic Radiology Physician
Primary
OP61602960
WA
Other
Enumeration date
05/20/2015
Last updated
06/11/2025
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