Individual
MS. DEBORA ANNE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MN, PMHNP
Contact information
Practice address
818 COMMERCIAL ST, SUITE 400, ASTORIA, OR 97103
(503) 338-6106
(503) 338-6126
Mailing address
P.O. BOX 1310, ASTORIA, OR 97103
(503) 338-6106
(503) 338-6126
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
081001680 N6
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
081001680N6
OR
Other
Enumeration date
10/17/2006
Last updated
04/20/2016
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