Individual
EMILY DANIELLE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3321 HAROLD DR NE, SALEM, OR 97305-1339
(503) 363-2021
Mailing address
PO BOX 17818, SALEM, OR 97305-7818
(503) 363-2021
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-25-5581
OR
175T00000X
Peer Specialist
24-CRM-2976
OR
Other
Enumeration date
11/06/2024
Last updated
01/29/2026
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