Individual
JOHN J STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1435 NE 4TH ST STE B, BEND, OR 97701-4268
(541) 306-4446
(541) 550-2011
Mailing address
1435 NE 4TH ST STE B, BEND, OR 97701-4268
(541) 306-4446
(503) 550-2011
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
18-CRM-349
OR
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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