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NPI Code Detail

MEDICARE: DENNIS H MARTIN PH.D

MEDICARE: DENNIS H MARTIN PH.D
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
1101YM0800XMental Health Counselor346OR

General Provider Information

NPI Number : 1407992332
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS H MARTIN PH.D
Provider Business Mailing Address
First Line : 1698 LIBERTY ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4348
Country : US
Telephone Number : 503-378-1977
Fax Number : 503-364-7272
Provider Business Practice Location Address
First Line : 1698 LIBERTY ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4348
Country : US
Telephone Number : 503-378-1977
Fax Number : 503-364-7272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 07/08/2007

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Directions to “ DENNIS H MARTIN PH.D” Practice Location

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