Individual
STACEY IRENE INLOES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
10209 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9782
(503) 353-3900
Mailing address
18848 ROSE RD, OREGON CITY, OR 97045-8929
(503) 830-3518
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
113490
OR
Other
Enumeration date
05/16/2017
Last updated
05/16/2017
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