Individual
STEPHANIE NICOLE LOVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5405 SE WOODWARD ST, PORTLAND, OR 97206-2168
(503) 916-5140
Mailing address
6836 N SMITH ST APT A, PORTLAND, OR 97203-2579
(503) 752-0730
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-10169687
OR
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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