Provider Demographics
NPI:1346434552
Name:MARTINEZ, RHONDA E (FNP-BC, ARNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:E
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:FNP-BC, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 JEFFERSON AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-3649
Mailing Address - Country:US
Mailing Address - Phone:360-802-0803
Mailing Address - Fax:360-802-0806
Practice Address - Street 1:1427 JEFFERSON AVE
Practice Address - Street 2:102
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-3649
Practice Address - Country:US
Practice Address - Phone:360-802-0803
Practice Address - Fax:360-802-0806
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN 00137405163WP2201X
WAAP60522728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7084338Medicaid
WAG8943796Medicare PIN