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1902875016
KENNETH LYLE MARTIN
TIGARD, OR
NPI
1902875016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: OR 10582)
Enumeration Date
2006-03-14
Last Update Date
2011-02-14
Business Address
Dr. KENNETH LYLE MARTIN M.D.
15298 SW ROYALTY PKWY
TIGARD, OR 97224-3904
Phone number: 503-620-0721
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Mailing Address
Dr. KENNETH LYLE MARTIN M.D.
15298 SW ROYALTY PKWY
TIGARD, OR 97224-3904
Phone number: 503-620-0721
Copy
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