Individual
DR. CAROLYN JOHANNA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 NE MOTHER JOESPH PLACE, VANCOUVER, WA 98664
(360) 514-2142
Mailing address
PO BOX 1600, VANCOUVER, WA 98668-1600
(360) 514-2142
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01067726B
IN
207P00000X
Emergency Medicine Physician
25889
AZ
207P00000X
Emergency Medicine Physician
Primary
MD 60131801
WA
207P00000X
Emergency Medicine Physician
MD27043
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831175462
—
MT
Enumeration date
12/15/2005
Last updated
07/21/2022
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