Individual
MISS STACEY MARIE DOERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 SW 45TH PL, CORVALLIS, OR 97333-1768
(541) 757-8068
Mailing address
1650 SW 45TH PL, CORVALLIS, OR 97333-1768
(541) 757-8068
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128715
—
OR
Enumeration date
10/26/2018
Last updated
10/26/2018
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