| Doctor Name: | KIMBERLY MARIE MARTINEZ |
| NPI Number: | 1083637680 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | 094006411N3 |
| Business Practice Address: | 2700 Se Stratus Ave Unit 304 Mcminnville, OR - 971286257 |
| Business Phone Number: | 5034346090 |
| Business Fax Number: | 5034743306 |
| Mailing Address: | 2700 Se Stratus Ave Unit 304, MCMINNVILLE |
| State: | OR |
| Postal Code: | 971286257 |
| Phone Number: | 5034346090 |
| Fax Number: | 5034743306 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 03/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 094006411N3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |