Individual
MR. COLLIN DEREK STOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
11900 SW GREENBURG RD, TIGARD, OR 97223-6453
(503) 620-5556
Mailing address
6145 SW BRUGGER ST, PORTLAND, OR 97219-4928
(503) 452-3610
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00407
OR
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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