Provider Demographics
NPI:1225097439
Name:MACRITCHIE, MARTHA J (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:J
Last Name:MACRITCHIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 E 12TH AVE
Mailing Address - Street 2:SUITE N-180
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3600
Mailing Address - Country:US
Mailing Address - Phone:541-683-4242
Mailing Address - Fax:541-343-5078
Practice Address - Street 1:677 E 12TH AVE
Practice Address - Street 2:SUITE N-180
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3600
Practice Address - Country:US
Practice Address - Phone:541-683-4242
Practice Address - Fax:541-343-5078
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14098174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR221358Medicaid
OR221358Medicaid
E22239Medicare UPIN