Individual provider Active NPI

Marty Eugene Mathison, LMP

  • Other Specialist/Technologist
  • Sunnyside, WA
National Provider Identifier
1659419398
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
License
MA00006441 Issued in WA
Practice address
711 E Lincoln Ave
Sunnyside, WA 98944-2318
Phone
(509) 839-4222
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X MA00006441 WA Primary

Addresses

Primary practice location

711 E Lincoln Ave
Sunnyside, WA 98944-2318

Mailing address

1201 NW Crescent Rd
Sunnyside, WA 98944-9669
Phone (509) 830-6515

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

State licenses

LicenseStateTypeSpecialty
MA00006441WAMDOther Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marty Mathison LMP Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1659419398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NW CRESCENT RD",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989449669",
            "telephone_number": "509-830-6515",
            "fax_number": "509-837-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442318",
            "telephone_number": "509-839-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHISON",
        "first_name": "MARTY",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "WA",
            "license": "MA00006441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.