Individual
DEBORAH M MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
701 SENECA ST STE 646C, BUFFALO, NY 14210-1351
(716) 995-4450
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60097965
WA
363L00000X
Nurse Practitioner
AP60197717
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
AP60197717
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477843647
—
WA
05
—
2012262
—
WA
Enumeration date
04/08/2011
Last updated
10/28/2019
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