Individual
MS. MEGAN LILAH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(800) 813-2000
Mailing address
4743 SE 75TH AVE, PORTLAND, OR 97206-4351
(503) 975-4097
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
R7876
OR
Other
Enumeration date
10/15/2021
Last updated
01/09/2023
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