Individual
NANCY ANN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8007 N LEAVITT AVE, PORTLAND, OR 97203-3722
(503) 730-9808
Mailing address
8007 N LEAVITT AVE, PORTLAND, OR 97203-3722
(503) 730-9808
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19820
OR
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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