Active NPI
Ken Martin, PHARM.D.
- Nuclear Pharmacist
- Tacoma, WA
National Provider Identifier
1457522948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Pharmacist
- License
- PH00021477
- Practice address
- 3615 Pacific Ave
Tacoma, WA 98418-7921 - Phone
- (253) 682-4660
- NPI assigned
- Mar 12, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nuclear Pharmacist | 1835N0905X | PH00021477 | WA | Primary |
Addresses
Primary practice location
3615 Pacific Ave
Tacoma, WA 98418-7921
Mailing address
4605 SW 328TH PL
Federal Way, WA 98023-1925
Phone (425) 275-3890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00021477 | WA | MD | Nuclear Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205280000000",
"number": "1457522948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4605 SW 328TH PL",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980231925",
"telephone_number": "425-275-3890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 PACIFIC AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984187921",
"telephone_number": "253-682-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KEN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-12",
"last_updated": "2008-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835N0905X",
"taxonomy_group": "",
"desc": "Pharmacist, Nuclear",
"state": "WA",
"license": "PH00021477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.