KIMO MARTIN (NPI# 1134693856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134693856 |
| Entity Type | Individual |
| Full Name | KIMO MARTIN |
| Practice Address |
1600 Lane St Seattle WA 98144 |
| Practice Telephone | 2066822371 |
| Mailing Telephone | 2066822371 |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | CG60917667 | WA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 457632614 | 05 |
| Street Address |
1600 LANE ST |
| City | SEATTLE |
| State | WA |
| Zip Code | 98144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558975235 | Miranda Plummer | Counselor | 2122 S Jackson Street, Seattle, WA 98144 | 2020-09-01 |
| 1891337457 | Alyson Paris | Counselor | 2100 24th Ave S, Suite 260, Seattle, WA 98144 | 2019-10-15 |
| 1912558370 | Marco Antonio Medina Sotelo | Counselor | 113 23rd Avenue South, Seattle, WA 98144 | 2019-09-26 |
| 1952865909 | John Thomas Hogan | Counselor | 1600 S Lane, Seattle, WA 98144 | 2019-01-23 |
| 1952875791 | Rainier Chiropractic Accident and Injury Ps | Massage Therapist | 2326 Rainier Ave S, Ste B, Seattle, WA 98144 | 2019-01-15 |
| 1174097083 | Seann M Combs | Counselor | 1600 S Lane St, Seattle, Wa 98144, Seattle, WA 98144 | 2019-01-14 |
| 1922571587 | Cristina Wirkala | Registered Nurse | Crisis Solutions Center, 1600 South Lane Street, Seattle, WA 98144 | 2019-01-07 |
| 1215405162 | Vickie Barron | Counselor | 3401 Rainier Ave S, Suite B, Seattle, WA 98144 | 2018-11-08 |
| 1164906509 | Julie Seddon Cabell | Counselor | Central Youth and Family Services, 1901 Mlk Jr Way S., Seattle, WA 98144 | 2018-09-21 |
| 1356831556 | Samantha Fonteyne-crescioni | Doula | 2915 Rainier Ave S Apt 209, Seattle, WA 98144 | 2018-05-14 |
| Find all providers in zip 98144 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240301 | Aleric Hughes | Peer Specialist | 1200 Sw Holden St, Seattle, WA 98106-2054 | 2020-06-23 |
| 1295356483 | Yvette Marie Sampson | Peer Specialist | Josephinum C/o Crew, 1902 2nd Ave., Seattle, WA 98101 | 2020-04-29 |
| 1881252575 | Darryl Lee Wright | Peer Specialist | Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 | 2019-05-29 |
| 1376007286 | Fritzina Fay Johnson | Peer Specialist | 1420 Western Ave Apt 1004, Seattle, WA 98101-2041 | 2019-01-24 |
| 1548735897 | Kris Glen Hills | Peer Specialist | 28 S Brandon St, Seattle, WA 98134-2428 | 2018-10-12 |
| 1558960237 | Nicolette Vandenberg | Peer Specialist | 2100 24th Ave S, Seattle, WA 98144-4637 | 2020-10-22 |
| 1649878562 | Jay Thomas Scott | Peer Specialist | 222 Wall St, Seattle, WA 98121-1431 | 2020-10-13 |
| 1699372219 | Jody Orr | Peer Specialist | 2100 24th Ave S, Seattle, WA 98144-4637 | 2020-10-06 |
| 1902410970 | Sheridan Elizabeth Turner | Peer Specialist | 1600 S Lane St, Seattle, WA 98144-2810 | 2020-09-07 |
| 1952914574 | Christina M Bresina | Peer Specialist | 901 Rainier Ave S, Seattle, WA 98144-2839 | 2020-08-24 |
| Find all providers in SEATTLE | ||||
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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.