Provider Demographics
NPI:1255536116
Name:TOWER, MARTHA JO (CNM, ARNP)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:JO
Last Name:TOWER
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-1418
Mailing Address - Country:US
Mailing Address - Phone:509-548-6520
Mailing Address - Fax:509-548-2373
Practice Address - Street 1:900 FERRY ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3405
Practice Address - Country:US
Practice Address - Phone:509-662-2013
Practice Address - Fax:509-662-7896
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004785363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA363LW0102XOtherARNP TAXONOMY CODE
WA367A00000XOtherCNM TAXONOMY CODE
WA363LW0102XOtherARNP TAXONOMY CODE