Individual
MR. ROGER F MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
18610 NW CORNELL RD, SUITE 100, HILLSBORO, OR 97124-9223
(503) 216-9360
(503) 216-9363
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01371
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17685028
—
NM
05
—
500604720
—
OR
05
—
795164
—
AZ
Enumeration date
11/17/2006
Last updated
03/22/2021
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