Provider Demographics
NPI:1972086965
Name:CHRISTOPHER MARTINEZ
Entity Type:Organization
Organization Name:CHRISTOPHER MARTINEZ
Other - Org Name:APEX BALANCE AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:360-379-2436
Mailing Address - Street 1:190 PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:PORT LUDLOW
Mailing Address - State:WA
Mailing Address - Zip Code:98365-9620
Mailing Address - Country:US
Mailing Address - Phone:208-922-0869
Mailing Address - Fax:
Practice Address - Street 1:2200 W SIMS WAY STE 101
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-2221
Practice Address - Country:US
Practice Address - Phone:208-920-2089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604327610OtherSTATE OF WASHINGTON