Individual
MISS MARTHA LOUISE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
2538 NE BROADWAY ST STE C, PORTLAND, OR 97232-1872
(503) 282-8600
Mailing address
2319 SE 58TH AVE, PORTLAND, OR 97215-4011
(971) 570-1544
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00651
OR
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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