Individual
STASHA ANNE HORNBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CDE
Contact information
Practice address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9750
(503) 571-3040
(503) 571-3095
Mailing address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9750
(503) 571-3040
(503) 571-3095
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
860
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028078
—
OR
05
—
8440547
—
WA
Enumeration date
10/24/2005
Last updated
03/07/2022
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