Provider Demographics
NPI:1487043634
Name:WITKOWSKA, MARTYNA
Entity Type:Individual
Prefix:
First Name:MARTYNA
Middle Name:
Last Name:WITKOWSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 SE MORRISON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2300
Mailing Address - Country:US
Mailing Address - Phone:503-726-3834
Mailing Address - Fax:503-726-3835
Practice Address - Street 1:527 SE MORRISON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2300
Practice Address - Country:US
Practice Address - Phone:503-726-3834
Practice Address - Fax:503-726-3835
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker