Individual
DR. MARTHA KSEPKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402
(253) 761-4200
(253) 761-4201
Mailing address
C/O BWR INNOVATIONS 3471 S. UNIVERSITY DRIVE, FARGO, ND 58104
(701) 552-5271
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD471052
PA
2085R0202X
Diagnostic Radiology Physician
MD60855833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0393502
LNI-TRA REST OF WA
WA
01
—
0393575
LNI-TRA KING COUNTY
WA
01
—
0393577
LNI-UAOM
WA
01
—
0393578
LNI-DINW
WA
01
—
0393581
LNI-CMBC
WA
05
—
2103308
—
WA
Enumeration date
03/21/2012
Last updated
10/24/2022
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