Individual
KRISTEN JOY STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-9199
Mailing address
500 NE MULTNOMAH ST, STE. 100, PORTLAND, OR 97232-2023
(503) 571-9199
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201394267CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
810165
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295078401
—
TX
05
—
295078402
—
TX
01
—
P01097801
RAILROAD MEDICARE
TX
Enumeration date
12/10/2009
Last updated
08/18/2015
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