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Individual

JOHN TRAVIS STACY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
16535 SW TUALATIN VALLEY HWY, BEAVERTON, OR 97003-5143
(503) 649-5651
Mailing address
16535 SW TUALATIN VALLEY HWY, BEAVERTON, OR 97003-5143
(503) 649-5651

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
OR

Other

Enumeration date
01/30/2026
Last updated
01/30/2026
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