Individual
MR. MARTIN SHELDON PONNECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNFA
Contact information
Practice address
3319 RACINE ST, SUITE 202, BELLINGHAM, WA 98226-6607
(360) 922-0202
(360) 543-7919
Mailing address
3319 RACINE ST, SUITE 202, BELLINGHAM, WA 98226-6607
(360) 922-0202
(360) 543-7919
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN00102728
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24807200
GROUP HEALTH PROVIDER NUM
WA
01
—
47092
L&I PROVIDER NUMBER
WA
05
—
9633934
—
WA
Enumeration date
01/04/2007
Last updated
07/09/2007
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