Individual
MR. JESSE STUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 S STATE ST STE 200G, LAKE OSWEGO, OR 97034-3900
(503) 636-3028
(503) 636-1837
Mailing address
101 S STATE ST STE 200G, LAKE OSWEGO, OR 97034-3900
(503) 636-3028
(503) 636-1837
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305204961
VA
225100000X
Physical Therapist
Primary
6416
OR
Other
Enumeration date
04/19/2007
Last updated
05/04/2011
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