Basic Information
| Provider Information | |||||||||
| NPI: | 1013007822 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINJE | ||||||||
| FirstName: | MARTHA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 421 | ||||||||
| Address2: | |||||||||
| City: | LIBERTY LAKE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 990190421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099448910 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16528 DESMET CT | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992163522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099448910 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 03/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA10003924 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | MED-PAC-LIC-42399 | MT | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 1117 | AK | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.