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Individual

MARTHA C PAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1919 112TH ST SW, EVERETT, WA 98204-3784
(425) 513-1600
Mailing address
5870 HIATUS RD, REGIONAL ADMIN OFFICE, TAMRAC, FL 33321-6424
(954) 377-3074
(865) 560-7110

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004551
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0175422
LIWA
WA
01
2414PA
BSWA
WA
05
8364077
WA
Enumeration date
06/17/2006
Last updated
09/27/2024
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