Individual
JANA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3543 NE BROADWAY ST, PORTLAND, OR 97232-1820
(971) 351-2270
Mailing address
7804 SE CARLTON ST, PORTLAND, OR 97206-6321
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25932
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25932
STATE-ISSUED LICENSE
OR
Enumeration date
08/26/2020
Last updated
08/26/2020
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