Individual
MRS. JENNIFER ELLEN CAROLINE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6312 SW CAPITOL HWY # 137, PORTLAND, OR 97239-1938
(503) 201-1606
Mailing address
6312 SW CAPITAL HWY, 137, PORTLAND, OR 97239-2880
(503) 201-1606
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20083004LPN
OR
Other
Enumeration date
04/11/2008
Last updated
05/13/2024
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