DR. KENNETH LYLE MARTIN (NPI# 1902875016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902875016 |
| Entity Type | Individual |
| Full Name | DR. KENNETH LYLE MARTIN |
| Credential | M.D. |
| Practice Address |
15298 Sw Royalty Pkwy Tigard OR 97224-3904 |
| Practice Telephone | 5036200721 |
| Practice Fax Number | 5039681181 |
| Mailing Telephone | 5036200721 |
| Mailing Fax Number | 5039681181 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2011-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 10582 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 167387 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285232579 | Kenneth Martin | Technician | 138 Ivy Rd, Lerona, WV 25971 | 2020-10-09 |
| 1467085274 | Kenneth Martin | Pharmacist | 1811 West Govt St, Brandon, MS 39042-2106 | 2020-02-20 |
| 1578122065 | Kenneth Kevin Martin | Pharmacist | 700 Scott and White Dr # 1.112, College Station, TX 77845-6441 | 2019-06-10 |
| 1598064677 | Kenneth Martin | Physician Assistant | 26 Edgerton Drive, North Falmouth, MA 02556 | 2011-03-15 |
| 1154475952 | Kenneth Michael Martin | Physical Therapist | 2700 Lake Villa Dr Ste 100, Metairie, LA 70002-6782 | 2007-01-22 |
| 1760557334 | Kenneth R. Martin | Dentist | 694 S Willow Ave, Cookeville, TN 38501-3882 | 2006-11-21 |
| 1093899007 | Kenneth Leon Martin | Counselor | 105 Paces Brook Ave, #10518, Columbia, SC 29212-1642 | 2006-10-25 |
| 1245261809 | Kenneth J Martin | Marriage & Family Therapist | 564 Market St, Suite 410, San Francisco, CA 94104-5404 | 2006-07-05 |
| 1093743858 | Kenneth Martin Jr. | Audiologist | 710 N High St, Longview, TX 75601-5330 | 2006-06-29 |
| 1699730689 | Kenneth Andrew Martin | Orthopaedic Surgery | 5320 W. Markham, Little Rock, AR 72205 | 2006-04-20 |
| Street Address |
15298 SW ROYALTY PKWY |
| City | TIGARD |
| State | OR |
| Zip Code | 97224-3904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992773295 | Frederick Sheldon Hakkinen | Internal Medicine | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2006-03-10 |
| 1306319603 | Mckayla Carmean-huls | Behavioral Analyst | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2019-01-09 |
| 1982186805 | Katelyn Rose Marelich | Behavioral Analyst | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2018-09-06 |
| 1659721280 | Brooke Morris Harkness | Optometrist | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2016-06-14 |
| 1922332584 | Eye Health Northwest P.C. | Ophthalmology | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2009-09-29 |
| 1528208899 | Thomas Marion Eberle | Internal Medicine | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2009-02-26 |
| 1720037328 | Vishnu Mohan | Internal Medicine | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973139 | Katherine Raineri | Psychologist | 7213 Sw Hazel Fern Rd, Tigard, OR 97224 | 2019-07-10 |
| 1871064618 | Stacey A Wenzel | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Rd.,suite 201, Tigard, OR 97224 | 2018-12-05 |
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1649759358 | Viktoriya A Chiliy | Behavior Technician | 15290 Sw Royalty Parkway, Tigard, OR 97224 | 2018-08-13 |
| 1609384866 | Rachel E King | Physical Therapist | 18040 Sw Lower Boones Ferry Rd Ste 200, Tigard, OR 97224 | 2018-01-22 |
| 1689190134 | Isabelle Cooper Klee Caballero | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Road Suite 201, Tigard, OR 97224 | 2017-08-16 |
| 1427573146 | Breanna M Sandefur | Behavior Technician | 15290 Sw Royalty Pkwy, Tigard, OR 97224 | 2017-08-03 |
| 1083141196 | Krista Espenship | Registered Nurse | 8032 Sw Ashford St, Tigard, OR 97224 | 2017-05-19 |
| 1275067928 | Emily Elizabeth Myers | Behavioral Analyst | 15290 Royalty Parkway, Tigard, OR 97224 | 2017-04-19 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| Find all providers in zip 97224 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396060331 | Bryan Schwartz | Internal Medicine | 12540 Sw Main St Ste 202, Tigard, OR 97223-6198 | 2010-04-01 |
| 1992773295 | Frederick Sheldon Hakkinen | Internal Medicine | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2006-03-10 |
| 1750771762 | Landmark Medical of Oregon PC | Internal Medicine | 9020 Sw Washington Square Rd, #100, Tigard, OR 97223-4436 | 2015-01-28 |
| 1841551041 | Thuy-tien Vo Pham | Internal Medicine | 12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223-3396 | 2012-06-04 |
| 1528208899 | Thomas Marion Eberle | Internal Medicine | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2009-02-26 |
| 1548417405 | Enrique Gomez Morayta | Internal Medicine | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2008-08-22 |
| 1427213230 | Christina A Kemper | Internal Medicine | 7632 Sw Durham Rd, Suite 130, Tigard, OR 97224-7584 | 2008-07-21 |
| 1346418266 | Murtaza Batla | Internal Medicine | 18040 Sw Lower Boones Ferry Rd Ste 100, Tigard, OR 97224 | 2008-02-13 |
| 1003019340 | Evagelia Baros | Internal Medicine | 12442 Sw Scholls Ferry Rd, Suite 106, Tigard, OR 97223-3396 | 2007-06-06 |
| 1336208388 | Milton Louis Blettel | Internal Medicine | 9900 Sw Hall Blvd, #200, Tigard, OR 97223 | 2006-12-06 |
| Find all providers in TIGARD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.