Healthcare Provider Details

I. General information

NPI: 1770633919
Provider Name (Legal Business Name): JAMES ALAN MARTIN L..AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 NE CORNELL RD A
HILLSBORO OR
97124
US

IV. Provider business mailing address

1747 NE 2ND PL
HILLSBORO OR
97124-2169
US

V. Phone/Fax

Practice location:
  • Phone: 503-640-3668
  • Fax:
Mailing address:
  • Phone: 503-640-3668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number90
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: