MARTIN J. HENDRICKS (NPI# 1407258957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407258957 |
| Entity Type | Individual |
| Full Name | MARTIN J. HENDRICKS |
| Credential | PA-C, ATC |
| Practice Address |
1930 Port of Tacoma Rd Tacoma WA 98421-3707 |
| Practice Telephone | 2532745521 |
| Practice Fax Number | 2532745525 |
| Mailing Telephone | 2532745521 |
| Mailing Fax Number | 2532745525 |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2016-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
A160075492 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363A00000X | Physician Assistant | PA60623356 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | WA | Student, Health Care |
| Street Address |
1930 PORT OF TACOMA RD |
| City | TACOMA |
| State | WA |
| Zip Code | 98421-3707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245381474 | Elmer M Casey Jr. | Emergency Medicine | 1930 Port of Tacoma Rd, Tacoma, WA 98421-3707 | 2007-01-15 |
| 1316423833 | Hiedi Sutton | Nurse Practitioner | 1930 Port of Tacoma Rd, Tacoma, WA 98421-3707 | 2018-07-17 |
| 1427412071 | Richard Taing | Internal Medicine | 1930 Port of Tacoma Rd, Tacoma, WA 98421-3707 | 2016-04-11 |
| 1033513650 | Anna M Walen | Nurse Practitioner | 1930 Port of Tacoma Rd, Tacoma, WA 98421-3707 | 2014-10-09 |
| 1194099051 | Franciscan Medical Group | Preventive Medicine | 1930 Port of Tacoma Rd, Tacoma, WA 98421-3707 | 2012-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942669338 | Beverly Ann Shell | Counselor | Fort Mcdermitt Wellness Center, Suite 702g, Mcdermitt, NV 98421 | 2016-02-15 |
| 1366408353 | Paul S Darby | Preventive Medicine | 1930 Port of Tacoma Rd., Franciscan Occupational Health, Tacoma, WA 98421 | 2006-04-26 |
| 1639176431 | Daniel James Gage | Physical Therapist | Physical Therapy Department,madigan Army Medical Center, Fort Lewis Washington, Tacoma, WA 98421 | 2005-07-07 |
| 1619309416 | Sara Ann Wendler | Counselor | 101 East 26th St, Suite 200, Tacoma, WA 98421-1108 | 2013-08-02 |
| 1649213810 | Shera Mogri | Family Medicine | 101 E 26th St, Tacoma, WA 98421-1108 | 2006-06-14 |
| 1154635282 | Amanda Marie Lasher | Case Manager/Care Coordinator | 101 E 26th St, Tacoma, WA 98421-1108 | 2010-07-30 |
| 1962716092 | Diana Garrett | Case Manager/Care Coordinator | 101 E 26th St, Tacoma, WA 98421-1108 | 2010-07-30 |
| 1871807917 | Terry Lou Freed | Case Manager/Care Coordinator | 101 E 26th St, Tacoma, WA 98421-1108 | 2010-07-30 |
| 1437463692 | Tina Michelle Gray | Case Manager/Care Coordinator | 101 E 26th St, Tacoma, WA 98421-1108 | 2010-07-29 |
| 1518271774 | Marla K Griebenow | Case Manager/Care Coordinator | 101 E 26th St, Tacoma, WA 98421-1108 | 2010-07-29 |
| Find all providers in zip 98421 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1831663442 | Noah C Chance | Physician Assistant | 9040 Jackson Ave Attn:credentials, Tacoma, WA 98431-4604 | 2019-01-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| 1518448539 | Kimberly Bui | Physician Assistant | 112 S 8th St Ste 200, Tacoma, WA 98402-5294 | 2018-08-27 |
| 1568942621 | Michelle Lynn Scott | Physician Assistant | 1201 Pacific Ave Ste C6, Tacoma, WA 98402-4393 | 2018-08-17 |
| 1548770670 | Bradley Richard Poe | Physician Assistant | 209 M.l.k. Jr Way, Tacoma, WA 98405 | 2017-10-03 |
| 1326588369 | Alyssa K. Leaning | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2017-02-23 |
| 1356609218 | Rebecca Ann Sciandra | Physician Assistant | 9040a Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-7037 | 2012-04-30 |
| 1023392529 | Kristie Michelle Mattern | Physician Assistant | 5427 S Birmingham St, Tacoma, WA 98409-5417 | 2011-10-03 |
| 1700100385 | Colleen Anne Carette | Physician Assistant | 1500 N. Warner St., #1035, Tacoma, WA 98416-1035 | 2010-03-25 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.