NPI | 1902982309 |
---|---|
Former Name | MICHELLE RAYE MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30005779) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN00117248) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201400898NP) | |
Enumeration Date | 2006-10-27 |
Last Update Date | 2014-03-25 |