Individual
SHANE DEAN STOTTLEMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
63311 JAMISON ST, BEND, OR 97703-8288
(541) 585-7210
(541) 585-7209
Mailing address
422 NE ALPENVIEW LN, BEND, OR 97701-5096
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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