MEDICARE: CHRISTINA R MARTINEZ-CLAY LCSW

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	1041C0700X	Clinical Social Worker	06521	IA
2	1041C0700X	Clinical Social Worker	6471	OR
3	1041C0700X	Clinical Social Worker	L6471	OR

General Provider Information

NPI Number	:	1942371562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA R MARTINEZ-CLAY LCSW

Provider Business Mailing Address
First Line	:	175 W B ST
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-4575
Country	:	US
Telephone Number	:	541-971-2871
Fax Number	:	541-687-2063

Provider Business Practice Location Address
First Line	:	2440 WILLAMETTE ST STE 201
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405-3170
Country	:	US
Telephone Number	:	541-321-2278
Fax Number	:	541-246-8826

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	09/23/2021

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Directions to “ CHRISTINA R MARTINEZ-CLAY LCSW” Practice Location

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