Provider Demographics
NPI:1700567385
Name:MARTINEZ, MARIA CLEMENTINA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CLEMENTINA
Last Name:MARTINEZ
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 1:23332 NE HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:WOOD VILLAGE
Mailing Address - State:OR
Mailing Address - Zip Code:97060
Mailing Address - Country:US
Mailing Address - Phone:971-331-1193
Mailing Address - Fax:
Practice Address - Street 1:23332 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:WOOD VILLAGE
Practice Address - State:OR
Practice Address - Zip Code:97060
Practice Address - Country:US
Practice Address - Phone:971-331-1193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula