Provider Demographics
NPI:1679948442
Name:MARTIN, ASHLEY (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:400 INDIANA ST STE 390
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5067
Mailing Address - Country:US
Mailing Address - Phone:033-463-9600
Mailing Address - Fax:303-403-9919
Practice Address - Street 1:400 INDIANA ST STE 390
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5067
Practice Address - Country:US
Practice Address - Phone:303-463-9600
Practice Address - Fax:303-403-9919
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant