Individual
HALLIE ELIZABETH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1535 N WILLIAMS AVE, PORTLAND, OR 97227
(503) 238-2067
Mailing address
232 NW 6TH AVENUE, ATTN: CREDENTIALING, PORTLAND, OR 97209
(503) 501-5641
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
201705695RN
OR
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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