Individual
JENNIFER CHRISTINE STAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-9240
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-9240
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-05-24
OR
Other
Enumeration date
06/16/2014
Last updated
11/15/2016
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