Individual
BRENDA STAGEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 NW FLANDERS ST, PORTLAND, OR 97209-3941
(503) 827-3949
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
201390326RN
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/27/2013
Last updated
09/06/2013
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