Individual
KYLE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
2135 NE 54TH AVE, PORTLAND, OR 97213-2616
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201240773RN
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
201600382CRNA
OR
Other
Enumeration date
08/08/2013
Last updated
09/24/2025
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