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Individual

DR. DAN HENRY MARTIN

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
Primary
MD00026455
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1160415
WA
01
74120
L&I
WA
Enumeration date
04/17/2006
Last updated
07/08/2007
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