Provider Demographics
NPI:1063468718
Name:STANTON, MARTIN JOSEPH (PT)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:JOSEPH
Last Name:STANTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27500 102ND AVE NW
Mailing Address - Street 2:STE 1
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-8092
Mailing Address - Country:US
Mailing Address - Phone:360-629-7528
Mailing Address - Fax:360-629-7632
Practice Address - Street 1:3405 172ND ST NE
Practice Address - Street 2:STE 10
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-7717
Practice Address - Country:US
Practice Address - Phone:360-651-8880
Practice Address - Fax:360-651-9975
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPT00005038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8870986Medicare PIN