Provider Demographics
NPI:1093975054
Name:BISHOP, MARTIN T (MS, LMHC)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:T
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 W NELSON RD
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-8055
Mailing Address - Country:US
Mailing Address - Phone:360-681-0700
Mailing Address - Fax:360-683-2568
Practice Address - Street 1:77 W NELSON RD
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-8055
Practice Address - Country:US
Practice Address - Phone:360-681-0700
Practice Address - Fax:360-683-2568
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health