Individual
STEPHANIE NICOLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 N GRAHAM ST STE 415, PORTLAND, OR 97227-2006
(503) 413-3580
Mailing address
501 N GRAHAM ST STE 415, PORTLAND, OR 97227-2006
(503) 413-3580
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA207934
OR
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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