Individual
JONATHAN ENRIQUE MARTINEZ MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW // CSWA
Contact information
Practice address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(503) 517-8663
Mailing address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(503) 517-8663
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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