Individual
STACEY BUCKLEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
1900 MCLOUGHLIN BLVD, SUITE 68, OREGON CITY, OR 97045-1067
(503) 387-8000
(503) 387-8005
Mailing address
1900 MCLOUGHLIN BLVD, SUITE 68, OREGON CITY, OR 97045-1067
(503) 387-8000
(503) 387-8005
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
120315
OR
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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