Individual
ALLYSSA MARIE STACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7100 SW HAMPTON ST STE 223, TIGARD, OR 97223-8364
(503) 342-2510
Mailing address
7100 SW HAMPTON ST STE 223, TIGARD, OR 97223-8364
(503) 342-2510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/26/2025
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