Provider Demographics
NPI:1093512568
Name:GRACE ANNE MARTIN, PLLC
Entity type:Organization
Organization Name:GRACE ANNE MARTIN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:509-670-3819
Mailing Address - Street 1:302 E 28TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3070
Mailing Address - Country:US
Mailing Address - Phone:509-670-3819
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N STE 419
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8969
Practice Address - Country:US
Practice Address - Phone:509-670-3819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty