Provider Demographics
NPI:1437140688
Name:MARTINEZ, JOHN F (MSPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-5485
Mailing Address - Country:US
Mailing Address - Phone:503-435-2307
Mailing Address - Fax:
Practice Address - Street 1:2200 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-5444
Practice Address - Country:US
Practice Address - Phone:503-474-3524
Practice Address - Fax:503-474-1820
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR132560Medicare ID - Type Unspecified