Provider Demographics
NPI:1669718425
Name:MARTIN, MARTINA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARTINA
Other - Middle Name:
Other - Last Name:ROVENSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1560 N. 115TH STREET
Mailing Address - Street 2:SUITE G16B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133
Mailing Address - Country:US
Mailing Address - Phone:206-606-5800
Mailing Address - Fax:206-606-2825
Practice Address - Street 1:1560 N. 115TH STREET
Practice Address - Street 2:SUITE G16B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-606-5800
Practice Address - Fax:206-606-2825
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60328607363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health