Individual
STEPHANIE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2802 16TH AVE, FOREST GROVE, OR 97116-3118
(503) 746-3164
Mailing address
2802 16TH AVE, FOREST GROVE, OR 97116-3118
(503) 746-3164
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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