Individual
KATRINA BUBAS STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LDM
Contact information
Practice address
7304 SE 85TH AVE, PORTLAND, OR 97266-5712
(503) 307-5412
Mailing address
7304 SE 85TH AVE, PORTLAND, OR 97266-5712
(503) 307-5412
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD-10171645
OR
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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