Individual
PETER J MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
N. 115 CROSBY, TEKOA, WA 99033-0629
(509) 284-2423
(509) 284-3434
Mailing address
PO BOX 629, TEKOA, WA 99033-0629
(509) 284-2423
(509) 284-3434
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
025211PA10000093
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8349276
—
WA
Enumeration date
03/12/2007
Last updated
11/04/2013
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