Provider Demographics
NPI:1770837080
Name:MARTINEZ, AMOREENA LEE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:AMOREENA
Middle Name:LEE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 OAK ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1671
Mailing Address - Country:US
Mailing Address - Phone:503-874-4484
Mailing Address - Fax:
Practice Address - Street 1:210 OAK ST STE 2
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1671
Practice Address - Country:US
Practice Address - Phone:503-874-4484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16014172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist