Individual
TIANNA RENEE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
19691 SUN CIR, WEST LINN, OR 97068-1913
(503) 250-0648
Mailing address
19691 SUN CIR, WEST LINN, OR 97068-1913
(503) 250-0648
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11857
OR
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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