# STARK MEDICAL, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316107782
- **Authorized official:** BRENDA L STARK BS/BM (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (541) 889-2244

## Contact information

- **Practice address:** 932 W IDAHO AVE STE 100, ONTARIO, OR 97914-2155
- **Practice address phone:** (541) 889-2244
- **Practice address fax:** (541) 889-2626
- **Mailing address:** PO BOX J, ONTARIO, OR 97914-0020
- **Mailing address phone:** (541) 889-2244
- **Mailing address fax:** (541) 889-2626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207KA0200X | Allergy Physician | — | NULL | — |
| 207KA0200X | Allergy Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/10/2008
- **Last updated:** 06/10/2008