Provider Demographics
NPI:1477193753
Name:MARTIN, JONATHAN PAXMAN (DC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PAXMAN
Last Name:MARTIN
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 1:17410 HIGHWAY 99 STE 150
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-3632
Mailing Address - Country:US
Mailing Address - Phone:509-840-1701
Mailing Address - Fax:425-741-9927
Practice Address - Street 1:17410 HIGHWAY 99 STE 150
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-3632
Practice Address - Country:US
Practice Address - Phone:509-840-1701
Practice Address - Fax:425-741-0465
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11599236-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor