Provider Demographics
NPI:1538783154
Name:MARTIN, LIVINGSTON PFALZGRAF (MD)
Entity type:Individual
Prefix:DR
First Name:LIVINGSTON
Middle Name:PFALZGRAF
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 KITSAP WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-2447
Mailing Address - Country:US
Mailing Address - Phone:360-782-5826
Mailing Address - Fax:360-782-5899
Practice Address - Street 1:314 NE THORNTON PL
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-9000
Practice Address - Country:US
Practice Address - Phone:206-528-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61321643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine