Active NPI
Dan Henry Martin, MD
- Diagnostic Radiology Physician
- Puyallup, WA
National Provider Identifier
1841254752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD00026455
- Practice address
- 222 15TH Ave SE
Puyallup, WA 98372-3754 - Phone
- (253) 841-4353
- Fax
- (253) 581-5698
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD00026455 | WA | Primary |
Addresses
Primary practice location
222 15TH Ave SE
Puyallup, WA 98372-3754
Mailing address
7424 Bridgeport Way W
Suite 103
Lakewood, WA 98499-8120
Phone (253) 841-4353
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1160415 | Medicaid | WA | |
| 74120 | Other | WA | L&I |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00026455 | WA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance | Past | Accepting new patients | |
| Tra-Minw P S | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1083802946
-
- Radiology Clinic/Center
- Tacoma, WA
- NPI 1396814166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1841254752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7424 BRIDGEPORT WAY W",
"address_2": "SUITE 103",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984998120",
"telephone_number": "253-841-4353",
"fax_number": "253-581-5698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 15TH AVE SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723754",
"telephone_number": "253-841-4353",
"fax_number": "253-581-5698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "DAN",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD00026455",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1160415",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "74120",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.