Individual
WENDY VANNESSA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCII
Contact information
Practice address
1300 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1150
(503) 535-1191
Mailing address
149 NE 168TH AVE, PORTLAND, OR 97230-6209
(503) 535-1150
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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