Provider Demographics
NPI:1083732697
Name:HEHN, MARTIN RUSSELL (DC)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:RUSSELL
Last Name:HEHN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032
Mailing Address - Country:US
Mailing Address - Phone:253-850-9780
Mailing Address - Fax:253-850-6445
Practice Address - Street 1:319 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032
Practice Address - Country:US
Practice Address - Phone:253-850-9780
Practice Address - Fax:253-850-6445
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH2965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU48996Medicare UPIN
WAG8800080Medicare ID - Type UnspecifiedCHIROPRACTIC