Individual
MADELYN AILEEN STOCKSLAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MATRN, LAT
Contact information
Practice address
721 SW 4TH AVE, CANBY, OR 97013-3999
(503) 263-7200
Mailing address
17124 SW APPLEDALE RD UNIT 304, BEAVERTON, OR 97007-2035
(310) 612-1071
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-10245509
OR
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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