Provider Demographics
NPI:1871634840
Name:MARTHA A. BIRD, M.D., INC., P.S.
Entity Type:Organization
Organization Name:MARTHA A. BIRD, M.D., INC., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF THE CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-692-9209
Mailing Address - Street 1:9230 BAYSHORE DR NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9162
Mailing Address - Country:US
Mailing Address - Phone:360-692-9209
Mailing Address - Fax:360-692-7337
Practice Address - Street 1:9230 BAYSHORE DR NW
Practice Address - Street 2:SUITE 101
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9162
Practice Address - Country:US
Practice Address - Phone:360-692-9209
Practice Address - Fax:360-692-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-10
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000296762084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty