Individual
MS. STACEY ANN AGEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2120 EXCHANGE ST, SUITE 200, ASTORIA, OR 97103-3365
(503) 325-5360
(503) 325-9373
Mailing address
PO BOX 176, WHEELER, OR 97147-0176
(800) 368-5182
(844) 717-0711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
087006402N3
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
239443
—
OR
Enumeration date
11/16/2005
Last updated
04/19/2017
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