Individual
JON LEE MARTINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2330 NE SISKIYOU ST, PORTLAND, OR 97212-2471
(503) 528-0757
(503) 528-0764
Mailing address
PO BOX 847, PORTLAND, OR 97207-0847
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
201142826RN
OR
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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