Individual
TINA A STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
906 MAIN AVE, TILLAMOOK, OR 97141-3816
(503) 842-8201
(503) 815-1870
Mailing address
906 MAIN AVE, TILLAMOOK, OR 97141-3816
(503) 842-8201
(503) 815-1870
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
10/18/2022
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