MEDICARE: MOVEMENT HEALTH AND SPORTS MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0900X	Internist Chiropractor

General Provider Information

NPI Number	:	1316759939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOVEMENT HEALTH AND SPORTS MEDICINE

Provider Business Mailing Address
First Line	:	1837 PACIFIC AVE APT 112
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-3135
Country	:	US
Telephone Number	:	503-359-9557
Fax Number	:

Provider Business Practice Location Address
First Line	:	1837 PACIFIC AVE APT 112
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-3135
Country	:	US
Telephone Number	:	503-359-9557
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	JENNIFER R MARTENS
Credential	:	DC, MS
Telephone Number	:	503-359-9557

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	01/21/2025

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Directions to “MOVEMENT HEALTH AND SPORTS MEDICINE ” Practice Location

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