Individual
TAMARA STUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
Mailing address
PO BOX 563, MONMOUTH, OR 97361-0563
(503) 871-2375
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000109941
OR
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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