Individual provider Active NPI

Julie Catherine Martin

  • School Registered Nurse
  • Granite Falls, WA
National Provider Identifier
1831858968
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN60029019 Issued in WA
Practice address
205 N Alder Ave
Granite Falls, WA 98252-8907
Phone
(360) 283-4000
Fax
(360) 283-4417
NPI assigned
Dec 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN60029019 WA Primary

Addresses

Primary practice location

205 N Alder Ave
Granite Falls, WA 98252-8907

Mailing address

212 Avenue H
Snohomish, WA 98290-2630
Phone (425) 320-6677

Other identifiers 2

IdentifierTypeStateIssuer
60029019OtherWAWASHINGTON STATE DEPARTMENT OF HEALTH
RN60029019OtherWAWASHINGTON STATE DEPARTMENT OF HEALTH

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
RN60029019WAMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1831858968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 AVENUE H",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902630",
            "telephone_number": "425-320-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N ALDER AVE",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528907",
            "telephone_number": "360-283-4000",
            "fax_number": "360-283-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JULIE",
        "middle_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WA",
            "license": "RN60029019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "60029019",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "RN60029019",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite Falls, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.