Individual
MARTHA A BANKHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
390 9TH ST, FLORENCE, OR 97439-9470
(541) 997-7134
Mailing address
1115 SE 164TH AVE, DEPT. 358, VANCOUVER, WA 98683-9324
(360) 729-1411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA180422
OR
363A00000X
Physician Assistant
Primary
PA60826975
WA
Other
Enumeration date
11/14/2016
Last updated
11/30/2021
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