Individual
MARIA ROCHELLE CARREON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9230 SKY ISLAND DR E, BONNEY LAKE, WA 98391-7385
(253) 750-6000
(253) 750-6100
Mailing address
9230 SKY ISLAND DR E, BONNEY LAKE, WA 98391-7385
(253) 750-6000
(253) 750-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA08438100
NJ
207Q00000X
Family Medicine Physician
4301091747
MI
207Q00000X
Family Medicine Physician
Primary
MD60120795
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2005491
—
WA
Enumeration date
05/29/2008
Last updated
04/15/2021
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