Individual
DR. C CHYRELLE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1130 SW MORRISON ST, SUITE 515, PORTLAND, OR 97205-2234
(971) 404-7461
(503) 638-7734
Mailing address
1130 SW MORRISON ST, SUITE 515, PORTLAND, OR 97205-2234
(971) 404-7461
(503) 638-7734
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1983
OR
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
1983
OR
103TF0200X
Forensic Psychologist
Primary
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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