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1396031209
DERRICK E MARTIN
PORTLAND, OR
NPI
1396031209
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2011-06-20
Last Update Date
2011-06-20
Business Address
DERRICK E MARTIN
55 NE GRAND AVE
PORTLAND, OR 97232
Phone number: 510-337-7950
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Mailing Address
DERRICK E MARTIN
55 NE GRAND AVE
PORTLAND, OR 97232
Phone number: 510-337-7950
Copy
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