Provider Demographics
NPI:1467557918
Name:SCZESNY-ALESHNICK, MARTINA (MD)
Entity Type:Individual
Prefix:
First Name:MARTINA
Middle Name:
Last Name:SCZESNY-ALESHNICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARTINA
Other - Middle Name:
Other - Last Name:SCZESNY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:33431 13TH PL S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6357
Practice Address - Country:US
Practice Address - Phone:253-874-7634
Practice Address - Fax:253-874-7635
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0009544207Q00000X
WAMD61376486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0106055YPVT01OtherBLUE SHEILD
VT8000693Medicaid
VT08P028OtherMVP
NH30010878Medicaid
VTOVN1625Medicaid
VTSCZE00029671OtherBLUE SHEILD
VT080156272Medicare ID - Type UnspecifiedRR MEDICARE
NH30010878Medicaid
VTVN1625Medicare ID - Type Unspecified