Organization
STONESOUP HRC
Active
Organization
STONESOUP HRC
Active
Other names
Stonesoup HRC, Street Leaves
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW PETERSON (ED)
(541) 231-5597
Entity
Organization
Contact information
Practice address
1235 SE OAK ST APT 2, PORTLAND, OR 97214-1498
(541) 231-5597
Mailing address
3439 NE SANDY BLVD, PMB 201, PORTLAND, OR 97232-1959
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
08/07/2026
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