Individual
MRS. STACY ELAINE LUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
9570 SW BARBUR BLVD, PORTLAND, OR 97219-5412
(971) 232-2234
Mailing address
9570 SW BARBUR BLVD STE 100, PORTLAND, OR 97219-5412
(971) 232-2234
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-24-4363
OR
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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