=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881520369
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. LIZZETTE ISABEL MARTINEZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2026
-----------------------------------------------------
Last Update Date | 06/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3321 W KENNEWICK AVE STE 150
-----------------------------------------------------
City | KENNEWICK
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99336-2968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-735-6446
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 134
-----------------------------------------------------
City | BOARDMAN
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97818-0134
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-371-1527
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175T00000X
-----------------------------------------------------
Taxonomy Name | Peer Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------