Individual provider Active NPI

Caitlin H Martin, MEDICAL STUDENT

  • Student in an Organized Health Care Education/Training Program
  • Vancouver, WA
National Provider Identifier
1396274940
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2613 H St
Vancouver, WA 98663-3047
Phone
(360) 798-7467
NPI assigned
Jun 7, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2613 H St
Vancouver, WA 98663-3047

Mailing address

309 E 2ND St
Pomona, CA 91766-1854
Phone (360) 798-7467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211103001689 OR Practitioner - Family Practice 9830447887 Reassigns benefits to 1 organization
I20211201001237 WA Practitioner - Family Practice 9830447887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 11, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 11, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 11, 2021 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396274940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "360-798-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 H ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633047",
            "telephone_number": "360-798-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CAITLIN",
        "middle_name": "H",
        "credential": "MEDICAL STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.