Molly Jean Martin, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP 60477361 Issued in WA

Practice address

2555 Marvin Rd NE
PMG SW Wa Hawks Prairie Im
Lacey, WA 98516-3138

Phone

(360) 923-4600

NPI assigned

Jul 18, 2014

Last updated

Jun 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jamestown S'Klallam Tribe

  dba Jamestown Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Sequim, WA
  • NPI 1134181555
  Medicare reassignment NPD
• Providence Health & Services - Washington

  • Rural Health Clinic/Center
  • Rochester, WA
  • NPI 1205931508
  Medicare reassignment NPD
• Providence Health & Services Washington

  dba Providence Medical Group SouthWest Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment
• Jamestown S'Klallam Tribe

  dba Jamestown Healing Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sequim, WA
  • NPI 1104901941
  NPD
• Jamestown S'Klallam Tribe

  dba Jamestown Family Health

  • Family Medicine Physician
  • Sequim, WA
  • NPI 1528809761
  NPD

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1417364761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 MARVIN RD NE",
            "address_2": "PMG SW WA HAWKS PRAIRIE IM",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163138",
            "telephone_number": "360-923-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 N 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Sequim",
            "state": "WA",
            "postal_code": "983823045",
            "country_code": "US",
            "telephone_number": "360-683-5900",
            "fax_number": "360-582-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MOLLY",
        "middle_name": "JEAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP 60477361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmartin549452@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "808 N 5th Ave",
            "city": "Sequim",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983823045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tracy K Marquis, LMP
• Emiko Marron-Currie
• Katherine Mary Marsh, PSY.D.
• Randy Marston, L.M.H.C.
• Alicia Ann Martin
• Ashlee Martinez
• Melina Martinez
• Rebecca Lynn Martinez, M.S. CCC-SLP
• Trevor John Marum, DC
• Hawk P Mason, LMT

• Family Nurse Practitioner in Lacey, WA
• Providers in Lacey, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.