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Individual

STANLEY WAYNE POWELL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS OTR/L

Contact information

Practice address
13073 SE 26TH ST APT D101, BELLEVUE, WA 98005-4262
(479) 651-8289
Mailing address
4 HILLS CT, ARKADELPHIA, AR 71923-5451
(479) 651-8289

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OTR2311
AR

Other

Enumeration date
07/23/2010
Last updated
07/23/2010
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