Provider Demographics
NPI:1720039621
Name:MILNER, MARTIN (ND)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:MILNER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22463 S EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OR
Mailing Address - Zip Code:97004-7611
Mailing Address - Country:US
Mailing Address - Phone:503-632-3633
Mailing Address - Fax:503-632-4343
Practice Address - Street 1:1330 SE 39TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4322
Practice Address - Country:US
Practice Address - Phone:503-232-1100
Practice Address - Fax:503-232-7751
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR548175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR159806Medicaid
ORAM2404200OtherDEA NUMBER