Individual
MR. MICHAEL J MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1724 W UNION AVE, TACOMA, WA 98405-2099
(253) 572-2663
(253) 752-1160
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
(206) 264-8689
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
MD00031212
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1084144
—
WA
01
—
193396800
OWCP
—
01
—
48529
DEPT OF LABOR & INDUSTRIE
WA
Enumeration date
06/09/2006
Last updated
01/25/2012
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