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Individual

AMANDA JOY MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
17066 BEATON RD SE, SUITE 170, MONROE, WA 98272-1002
(360) 863-0960
(360) 863-8710
Mailing address
17066 BEATON RD SE, SUITE 170, MONROE, WA 98272-1002
(360) 863-0960
(360) 863-8710

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00023980
WA

Other

Enumeration date
05/31/2007
Last updated
07/08/2007
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