Individual
DR. MARTIN LAREN GRAHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 15TH AVE SE, PUYALLUP, WA 98372-3754
(253) 841-4353
(253) 581-5698
Mailing address
7424 BRIDGEPORT WAY W, SUITE 103, LAKEWOOD, WA 98499-8120
(253) 841-4353
(253) 581-5698
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301030616
MI
2085R0202X
Diagnostic Radiology Physician
A24039
CA
2085R0202X
Diagnostic Radiology Physician
Primary
MD00012303
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74116
L&I
WA
05
—
8194904
—
WA
Enumeration date
04/14/2006
Last updated
07/08/2007
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