Individual
STEPHANIE MARIE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-I/PSS
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-12-11349
OR
175T00000X
Peer Specialist
THW000108332
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500843428
—
OR
05
—
500843554
—
OR
Enumeration date
07/31/2024
Last updated
10/22/2025
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