Individual
JULIE ANN MARTCHENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 418-5750
Mailing address
707 SW GAINES ST, PORTLAND, OR 97239-2901
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
099006977N2
OR
363LP0200X
Pediatric Nurse Practitioner
099006977RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000707
—
OR
Enumeration date
08/03/2006
Last updated
07/20/2007
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