Most Relevant Information
Provider Data
| NPI Number: | 1003313529 |
| Provider Name: | JULIE MARIE MARTIN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 10176695 |
Most Important Dates
| Enumeration Date: | 04/11/2018 |
| Last Updated: | 04/11/2018 |
Provider Practice Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393011
Practice Location Phone/Fax
| Phone: | 5034945466 |
| Fax: |
Provider Mailing Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393011
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |