Provider Demographics
NPI:1053207795
Name:MARTELL, TASHA M (CHW)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:M
Last Name:MARTELL
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 4TH ST NW STE 120
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3155
Mailing Address - Country:US
Mailing Address - Phone:218-444-2718
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 280
Practice Address - Street 2:
Practice Address - City:RED LAKE
Practice Address - State:MN
Practice Address - Zip Code:56671-0280
Practice Address - Country:US
Practice Address - Phone:218-679-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker