Individual
BRIDGET C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16770 SW EDY RD, SHERWOOD, OR 97140-9678
(503) 216-9600
(503) 216-9650
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD25795
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023121
—
OR
01
—
P00346620
RR MEDICARE
OR
Enumeration date
06/05/2006
Last updated
03/22/2021
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