Provider Demographics
NPI:1538305628
Name:MARTINEZ, ADRIANE LEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANE
Middle Name:LEE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22612 92ND AVE W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-4507
Mailing Address - Country:US
Mailing Address - Phone:206-999-5642
Mailing Address - Fax:
Practice Address - Street 1:22612 92ND AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4507
Practice Address - Country:US
Practice Address - Phone:206-999-5642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00157495163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN00157495Medicaid