Individual
CHARLES ROBERT MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3901 CREEKSIDE LOOP, SUITE 102, YAKIMA, WA 98902
(509) 248-6113
(509) 457-8941
Mailing address
2701 KING COURT, YAKIMA, WA 98902
(509) 248-6075
(509) 457-8941
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003868
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186246
L AND I
WA
05
—
8343691
—
WA
Enumeration date
04/13/2006
Last updated
07/08/2007
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