Individual provider Active NPI

Martha Graner, MSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1710990221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2840-LCSW Issued in OR
Practice address
811 NW 20TH Ave
Suite 103
Portland, OR 97209-1443
Phone
(503) 296-0788
Fax
(503) 296-0788
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2840-LCSW OR Primary
Clinical Social Worker 1041C0700X 9769-LCSW CA

Addresses

Primary practice location

811 NW 20TH Ave
Suite 103
Portland, OR 97209-1443

Mailing address

7419 NW Cornell Rd
Portland, OR 97229-6901
Phone (503) 296-0788

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
9769-LCSWCAMDClinical Social Worker
2840-LCSWORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710990221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7419 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296901",
            "telephone_number": "503-296-0788",
            "fax_number": "503-296-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 NW 20TH AVE",
            "address_2": "SUITE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091443",
            "telephone_number": "503-296-0788",
            "fax_number": "503-296-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANER",
        "first_name": "MARTHA",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "2840-LCSW",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "9769-LCSW",
            "primary": false
        }
    ],
    "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 Jul 8, 2007; 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.