Vanessa Martinez, | |
11740 Sw 68th Pkwy Ste 200, Tigard, OR 97223-9058 | |
(425) 477-4216 | |
Not Available |
Full Name | Vanessa Martinez |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 11740 Sw 68th Pkwy Ste 200, Tigard, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922335793 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 180015368 (Illinois) | Secondary |
101YM0800X | Counselor - Mental Health | C9563 (Oregon) | Primary |
Entity Name | Lifeline Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265160451 PECOS PAC ID: 3678948577 Enrollment ID: O20231120000820 |
Mailing Address | Practice Location Address |
---|---|
Vanessa Martinez, 5441 S Macadam Ave Ste R, Portland, OR 97239-6106 Ph: (847) 337-0492 | Vanessa Martinez, 11740 Sw 68th Pkwy Ste 200, Tigard, OR 97223-9058 Ph: (425) 477-4216 |
Matthew Harhai, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8915 Sw Center St, Tigard, OR 97223 Phone: 503-726-3740 | |
Brianna Uilani Kaalakea, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8915 Sw Center St, Tigard, OR 97223 Phone: 503-726-3690 | |
Miss Sheila Miranda, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8915 Sw Center St, Tigard, OR 97223 Phone: 503-726-3690 | |
John Patrick Cate, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8915 Sw Center St, Tigard, OR 97223 Phone: 503-726-3690 | |
Julia Adams-opperman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8915 Sw Center St, Tigard, OR 97223 Phone: 503-726-3690 | |
Arya Roerig, CADC 1 Counselor Medicare: Not Enrolled in Medicare Practice Location: 12540 Sw Main St Ste 202, Tigard, OR 97223 Phone: 503-906-9995 | |
Corbin Gronvold, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8915 Sw Center St, Tigard, OR 97223 Phone: 503-726-3740 |