Individual
LILLY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
133 NE 20TH AVE, PORTLAND, OR 97232-3020
(971) 385-5456
(503) 233-6387
Mailing address
232 NW 6TH AVENUE, ATTN: CREDENTIALING, PORTLAND, OR 97209
(503) 501-5641
(503) 294-4321
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L10969
OR
Other
Enumeration date
09/13/2018
Last updated
08/22/2025
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