Active NPI
Martina Mary Koller, M.D.
- Family Medicine Physician
- Seattle, WA
National Provider Identifier
1386797306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 00027370
- Practice address
- 320 NE 97TH St Ste C
Seattle, WA 98115-2042 - Phone
- (206) 656-7999
- Fax
- (206) 902-2006
- NPI assigned
- Jan 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00027370 | WA | Primary |
Addresses
Primary practice location
320 NE 97TH St Ste C
Seattle, WA 98115-2042
Mailing address
320 NE 97TH St Ste C
Seattle, WA 98115-2042
Phone (206) 656-7999
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1118678 | Medicaid | WA | |
| 0180024 | Other | WA | LNI WA STATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2019 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00027370 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739664000000",
"number": "1386797306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 NE 97TH ST STE C",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981152042",
"telephone_number": "206-656-7999",
"fax_number": "206-902-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 NE 97TH ST STE C",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981152042",
"telephone_number": "206-656-7999",
"fax_number": "206-902-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLLER",
"first_name": "MARTINA",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-21",
"last_updated": "2025-02-16",
"certification_date": "2025-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "00027370",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1118678",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LNI WA STATE",
"identifier": "0180024",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.