Individual
MRS. LYNN MARIE STABEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-1617
Mailing address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-1617
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
583591
OR
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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