Individual
STACY LEILANI WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1362
(541) 963-1883
(541) 963-1837
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-1883
(541) 963-1837
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
11323
MT
Other
Enumeration date
03/23/2007
Last updated
01/22/2010
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