Organization
PETER J. MARTIN
Active
Other names
Tekoa Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN ANN HARP (OFFICE MANAGER)
(509) 284-2423
Entity
Organization
Contact information
Practice address
NORTH 115 CROSBY STREET, TEKOA, WA 99033-0629
(509) 284-2423
Mailing address
PO BOX 629, N 115 CROSBY, TEKOA, WA 99033-0629
(509) 284-2423
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
601652856
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7069875
—
WA
05
—
7075971
—
WA
Enumeration date
03/12/2007
Last updated
10/16/2013
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