Individual
VIRGINIA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 SE BELMONT ST, PORTLAND, OR 97214-2815
(503) 963-7765
Mailing address
7410 N JORDAN AVE, PORTLAND, OR 97203-4451
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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