Individual
MS. DENISE E. STUNTZNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
Mailing address
125 CENTRAL AVE, STE 290, COOS BAY, OR 97420-2342
(541) 267-5151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3811
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
NORTH BEND MEDICAL CENTER GROUP NPI
OR
01
—
161133
NORTH BEND MEDICAL CENTER GROUP MEDICAID
OR
01
—
93-0635514
NORTH BEND MEDICAL CENTER GROUP TAX ID
OR
01
—
R0000WFBTV
NORTH BEND MEDICAL CENTER GROUP MEDICARE
OR
Enumeration date
06/09/2006
Last updated
11/06/2019
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