Individual
HEIDI MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3060 SE STARK ST, PORTLAND, OR 97214-3053
(503) 535-4700
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
5636
TN
225200000X
Physical Therapy Assistant
Primary
8827
OR
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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