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NPI Code Detail

MEDICARE: JENNIFER RENAE MARTENS DC, LMT

MEDICARE:   JENNIFER RENAE MARTENS  DC, LMT
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
1225700000XMassage Therapist023248OR
2225700000XMassage Therapist6420OR
3111N00000XChiropractor6420OR

General Provider Information

NPI Number : 1578092573
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RENAE MARTENS DC, LMT
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 : 503-214-8622
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 : 503-214-8622
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2017
Last Update Date : 05/07/2025

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Directions to “ JENNIFER RENAE MARTENS DC, LMT” Practice Location

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