Individual
KIMBERLY MARIE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2700 SE STRATUS AVE UNIT 304, MCMINNVILLE, OR 97128-6257
(503) 434-6090
(503) 474-3306
Mailing address
2700 SE STRATUS AVE UNIT 304, MCMINNVILLE, OR 97128-6257
(503) 434-6090
(503) 474-3306
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
094006411N3
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210707
—
OR
Enumeration date
07/25/2006
Last updated
03/05/2015
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