Individual
STACI RAE DONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC III, QMHP-C
Contact information
Practice address
2367 S ROOSEVELT DR, SEASIDE, OR 97138-6550
(503) 239-8400
Mailing address
1011 COMMERCIAL ST NE STE 110, SALEM, OR 97301-1036
(503) 983-9915
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19-03-02-22
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
02/11/2014
Last updated
08/24/2023
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