Active NPI
Ezekiel Martin, BA, PSS
- Peer Specialist
- Portland, OR
National Provider Identifier
1598137747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 2901 E Burnside St
Portland, OR 97214-1831 - Phone
- (503) 238-5203
- NPI assigned
- Oct 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | OR | Primary |
Addresses
Primary practice location
2901 E Burnside St
Portland, OR 97214-1831
Mailing address
2901 E Burnside
Portland, OR 97214
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
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445990400000",
"number": "1598137747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 E BURNSIDE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 E BURNSIDE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141831",
"telephone_number": "503-238-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "EZEKIEL",
"credential": "BA, PSS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-28",
"last_updated": "2015-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.