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Individual

STEPHANIE KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CHW

Contact information

Practice address
9605 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2078
(503) 879-2071
Mailing address
9605 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2002
(503) 879-2071

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
112693
OR

Other

Enumeration date
04/24/2025
Last updated
04/24/2025
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