Organization
EVERGREEN NEPHROLOGY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JACOB MARTIN MD (OWNER)
(253) 272-5881
Entity
Organization
Contact information
Practice address
1708 YAKIMA AVE, SUITE 107, TACOMA, WA 98405-5307
(253) 272-5881
(253) 383-0161
Mailing address
1708 YAKIMA AVE, SUITE 107, TACOMA, WA 98405-5307
(253) 272-5881
(253) 383-0161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00028956
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7089881
—
WA
Enumeration date
05/20/2006
Last updated
08/22/2020
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