Individual
TIFFANY MARIE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1621 W CARROLL AVE, CHICAGO, IL 60612-2501
(503) 756-2422
Mailing address
15355 SE OATFIELD RD, PORTLAND, OR 97267-3921
(503) 756-2422
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
302529
OR
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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