Provider Demographics
NPI:1851682777
Name:MARTIN, CHELSEY LEE (EMT-B)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:LEE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-5309
Mailing Address - Country:US
Mailing Address - Phone:425-586-0850
Mailing Address - Fax:
Practice Address - Street 1:2208 MADISON ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-5309
Practice Address - Country:US
Practice Address - Phone:425-586-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAES60071306374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide