Individual provider Active NPI

Juniper Martin, N.D.

  • Naturopath
  • Tigard, OR
National Provider Identifier
1104070168
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1621 Issued in OR
Practice address
11845 SW Greenburg Rd Ste 110
Tigard, OR 97223-6464
Phone
(971) 328-0071
Fax
(503) 443-2142
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Integrative Medicine Physician 202D00000X 1621 OR
Family Medicine Physician 207Q00000X 1621 OR
General Practice Physician 208D00000X 1621 OR
Naturopath 175F00000X 1621 OR Primary

Addresses

Primary practice location

11845 SW Greenburg Rd Ste 110
Tigard, OR 97223-6464

Mailing address

11845 SW Greenburg Rd Ste 110
Tigard, OR 97223-6464
Phone (971) 328-0071

Other practice location 1

4037 NE Tillamook St
Portland, OR 97212-5341
Phone (971) 328-0071

Other identifiers 1

IdentifierTypeStateIssuer
500648182MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1621ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suzanne Lawton, LLC Naturopath Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: juniper.martin@98838534094852.direct.elationemr.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1104070168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11845 SW GREENBURG RD STE 110",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236464",
            "telephone_number": "971-328-0071",
            "fax_number": "503-443-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11845 SW GREENBURG RD STE 110",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236464",
            "telephone_number": "971-328-0071",
            "fax_number": "503-443-2142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4037 NE Tillamook St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972125341",
            "country_code": "US",
            "telephone_number": "971-328-0071",
            "fax_number": "503-443-2142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JUNIPER",
        "name_prefix": "Dr.",
        "credential": "N.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "OR",
            "license": "1621",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "1621",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "1621",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500648182",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.