Provider Demographics
NPI:1356486211
Name:MARTINEZ, ANTHONY (TONY MARTINEZ, MSW)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:TONY MARTINEZ, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9634 NW NOTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-5285
Mailing Address - Country:US
Mailing Address - Phone:503-572-2869
Mailing Address - Fax:
Practice Address - Street 1:9634 NW NOTTAGE DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5285
Practice Address - Country:US
Practice Address - Phone:503-572-2869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health