Individual
TARA KAY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 S 43RD ST, RENTON, WA 98055-5714
(425) 228-3440
Mailing address
25246 NETWORK PL, CHICAGO, IL 60673-1252
(425) 656-4255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD60361936
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2009
Last updated
06/03/2013
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