Organization
STARK MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA L STARK (OFFICE MANAGER)
(541) 889-2244
Entity
Organization
Contact information
Practice address
932 W IDAHO AVE STE 100, ONTARIO, OR 97914-2155
(541) 889-2244
(541) 889-2626
Mailing address
PO BOX J, ONTARIO, OR 97914-0020
(541) 889-2244
(541) 889-2626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
079043254N1
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
200550081NP
OR
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/26/2013
Last updated
10/19/2022
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