Peter J. Martin
Organization Active NPI Family Medicine Physician · Tekoa, WA
NPI 1285766469 · NPPES record last updated Oct 16, 2013
Key facts
- NPI
- 1285766469
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 601652856 (WA)
- Legal business name
- PETER J. MARTIN
- Practice address
- North 115 Crosby Street
Tekoa, WA 99033-0629 - Phone
- (509) 284-2423
- NPI assigned
- Mar 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Robin Ann Harp
- Title
- Office Manager
- Phone
- (509) 284-2423
Practitioners 2
-
Timothy Moody, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 601652856 | WA | Yes |
Addresses
Primary practice location
North 115 Crosby Street
Tekoa, WA 99033-0629
Mailing address
PO Box 629
N 115 Crosby
Tekoa, WA 99033-0629
Phone (509) 284-2423
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7069875 | Medicaid | WA | |
| 7075971 | Medicaid | WA |
Other names
- Tekoa Medical Clinic
Other providers in Tekoa, WA
- Debra Diane Blaszak
- Peter J Martin
- Melissa Anne Osborne
- Peter J Martin
- Patricia L Primmer
- Tekoa Community Ambulance
- Tekoa Medical Foundation Inc
- Tekoa Operations LLC Tekoa Care Center
- Tekoa RX LLC
All providers in Tekoa, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.