Individual
STEPHANIE G DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 NE ALBERTA ST, PORTLAND, OR 97211-3976
(503) 249-7767
Mailing address
4905 NE 11TH AVE, PORTLAND, OR 97211-4527
(503) 442-5409
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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