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DERRICK E MARTIN SR.
NPI 1396031209
Counselor - Mental Health in Portland, OR

Active since June 20, 2011
55 NE GRAND AVE, PORTLAND, OR 97232(510) 337-7950 Get Directions Write a Review

NPPES record last updated: June 20, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Derrick E Martin Sr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERRICK E MARTIN SR. (NPI 1396031209) is an individual mental health provider in Portland, Oregon and active in the NPI registry since June 2011.

NPPES Registry Identity

NPI1396031209
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDERRICK E MARTIN SR.
Location Address55 NE GRAND AVEPortland, OR 97232
Mailing Address55 Ne Grand AvePortland, OR 97232 · (510) 337-7950
Phone(510) 337-7950
Sole ProprietorNo
Enumeration DateJune 20, 2011
✔ NPI 1396031209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
55 NE GRAND AVE, Portland, OR 97232
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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE HAY RN
Registered Nurse
55 NE GRAND AVE
PORTLAND, OR 97232
Multnomah County (971) 230-7653
MELISSA RUSSELL
Registered Nurse
55 NE GRAND AVE
PORTLAND, OR 97232
Multnomah County (971) 230-7653
ALISHA DONIELLE PORTER
Registered Nurse (Psychiatric/Mental Health, Adult)
55 NE GRAND AVE
PORTLAND, OR 97232
Multnomah County (503) 232-1099
MRS. KELLY LANE CHELUCCI RN
Registered Nurse (Psychiatric/Mental Health)
55 NE GRAND AVE
PORTLAND, OR 97232
Multnomah County (503) 232-1099
JORDON HEYNOSKI
Specialist
55 NE GRAND AVE
PORTLAND, OR 97232
Multnomah County (971) 230-7653
PHYLLIS WRIGHT
Registered Nurse
55 NE GRAND AVE
PORTLAND, OR 97232
Multnomah County (503) 232-1099
DR. LYLE L JOBE MD
Psychiatry & Neurology (Psychiatry)
55 NE GRAND AVE
PORTLAND, OR 97232
Multnomah County (503) 232-1099

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Martin's NPI number?

The NPI number for Derrick Martin is 1396031209. It was assigned to this individual provider in the NPPES registry on June 20, 2011.

Where is Derrick Martin located?

Derrick Martin practices at 55 NE Grand Ave, Portland, OR 97232. The listed phone number is (510) 337-7950.

What is Derrick Martin's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Derrick Martin was last updated on June 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.