Provider Demographics
NPI:1699827923
Name:ESCHENBURG, MARTINA CHRISTINA (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:CHRISTINA
Last Name:ESCHENBURG
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:M/S: G1- PMR
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-223-6746
Mailing Address - Fax:206-583-6459
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:M/S: G1- PMR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6746
Practice Address - Fax:206-583-6459
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8392136Medicaid
WAGAB32468Medicare PIN