Individual
JAZMINE DESIREE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMH-A
Contact information
Practice address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MC61515578
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC61515578
WA. ST. DOH
WA
05
—
MC61515578
—
WA
Enumeration date
03/21/2024
Last updated
04/15/2024
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