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NPI Code Detail

MEDICARE: VANESSA MARTINEZ

MEDICARE: VANESSA MARTINEZ
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 Counselor180015368IL
2101YM0800XMental Health CounselorC9563OR

General Provider Information

NPI Number : 1922335793
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA MARTINEZ
Provider Business Mailing Address
First Line : 5441 S MACADAM AVE STE R
Second Line :
City : PORTLAND
State : OR
Zip : 97239-6106
Country : US
Telephone Number : 847-337-0492
Fax Number :
Provider Business Practice Location Address
First Line : 11740 SW 68TH PKWY STE 200
Second Line :
City : TIGARD
State : OR
Zip : 97223-9058
Country : US
Telephone Number : 425-477-4216
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2009
Last Update Date : 04/11/2025

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Directions to “ VANESSA MARTINEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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