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Individual

MCKENNA MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
2701 NW VAUGHN ST STE 140, PORTLAND, OR 97210-5344
(503) 499-5200
Mailing address
6411 N ALBINA AVE APT 2, PORTLAND, OR 97217-1800
(503) 442-9028

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker

Other

Enumeration date
06/24/2021
Last updated
03/07/2022
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